| Citation: |
LU Qiaozhen, LI Rui, CAI Cheng, SUN Jingjing, LI Zhiqi. Effects of umbilical cord milking and delayed cord clamping on clinical outcomes of preterm infants within one week after birth[J]. Journal of Clinical Medicine in Practice, 2022, 26(15): 134-138. DOI: 10.7619/jcmp.20220542
|
To compare the effects of umbilical cord milking and delayed cord clamping on clinical outcomes of preterm infants with gestational age of 28 to 36 weeks born for one week, and to explore whether delayed umbilical cord milking can be used to replace delayed umbilical cord clamping in emergency situations.
A total of 123 premature infants with gestational age of 28 to 36 weeks born in March 2019 to May 2020 were selected as study objects, among whom 60 patients with odd birth dates were included in umbilical cord milking group and 63 patients with even birth dates were included in delayed umbilical cord clamping group. A total of 64 preterm infants of the same gestational age born for six months before implementation of research were selected as immediate umbilical cord clamping group. The indicators within 1 h of birth (blood pressure, body temperature, microscale blood glucose, pH value of umbilical cord blood, hemoglobin) and indicators within 1 week of birth (neonatal anemia, feeding problems, respiratory diseases, incidence of intracranial hemorrhage and blue light therapy rate, oxygen therapy rate) in three groups of premature infants.
The systolic blood pressure of premature infants within 1 hour after birth in the umbilical cord milking group and delayed umbilical cord clamping group was(62.70±7.03) mmHg and (61.60±6.06) mmHg, which were higher than (57.02±7.92) mmHg in the immediate umbilical cord clamping group (P < 0.05), but there was no significant difference between the umbilical cord milking group and delayed umbilical cord clamping group in systolic blood pressure(P>0.05). The mean arterial pressure of the umbilical cord milking group was (43.10±6.10) mmHg, which was higher than (41.48±4.13) mmHg in the delayed umbilical cord clamping group and (40.45±6.03) mmHg in the immediate umbilical cord clamping group (P < 0.05), but no significant difference in mean arterial pressure was found between the immediate umbilical cord clamping group and delayed umbilical cord clamping group(P>0.05). The hemoglobin level in 1 hour after birth in the umbilical cord milking group and delayed umbilical cord clamping group was (204.95±22.65) g/L and (205.19±22.15) g/L, which was higher than (191.31±25.70) g/L in the immediate umbilical cord clamping group (P < 0.05), and there was no significant difference in hemoglobin level between the umbilical cord milking group and the delayed umbilical cord clamping group (P>0.05). There were no significant differences in body temperature, umbilical cord blood pH and microblood glucose among the three groups (P>0.05). Within 1 week after birth, the phototherapy rates of the umbilical cord milking group and delayed umbilical cord clamping group were 83.33% and 85.71%, respectively, which were significantly higher than 62.50% in the immediate umbilical cord clamping group (P < 0.05), while the oxygen rates of the umbilical cord milking group and the delayed umbilical cord clamping group were 11.67% and 17.46%, which were significantly lower than 35.94% in the immediate umbilical cord clamping group (P < 0.05). There were no significant differences in anemia, feeding problems, respiratory diseases and incidence of intracranial hemorrhage among the three groups (P>0.05).
Umbilical cord milking and delayed umbilical cord clamping can increase postnatal blood pressure and hemoglobin, decrease oxygen therapy rate in preterm infants, and have no increased adverse outcomes. For premature infants aged 28 to 36 weeks, umbilical cord milking can be an alternative for delayed umbilical cord clamping for placental transfusion in emergency situations.
| [1] |
STRAÑÁK Z, FEYEREISLOVÁ S, KORCEK P, et al. Placental transfusion and cardiovascular instability in the preterm infant[J]. Front Pediatr, 2018, 6: 39. doi: 10.3389/fped.2018.00039
|
| [2] |
KATHERIA A C, LAKSHMINRUSIMHA S, RABE H, et al. Placental transfusion: a review[J]. J Perinatol, 2017, 37(2): 105-111. doi: 10.1038/jp.2016.151
|
| [3] |
RAMJI S. Delayed cord clamping and umbilical cord milking at birth[J]. Indian Pediatr, 2015, 52(9): 749.
|
| [4] |
冯琪. 新生儿脐带结扎策略及其研究进展[J]. 中华围产医学杂志, 2021, 24(3): 169-172. doi: 10.3760/cma.j.cn113903-20201210-01220
|
| [5] |
马如越, 孙克, 陈记娜, 等. 不同脐带处理策略对新生儿临床结局及检验指标的影响[J]. 实用妇产科杂志, 2021, 37(11): 870-875. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ202111020.htm
|
| [6] |
王雪茵, 杨慧霞. 延迟脐带结扎对母儿健康影响的研究进展[J]. 中华围产医学杂志, 2020, 23(1): 39-43. doi: 10.3760/cma.j.issn.1007-9408.2020.01.008
|
| [7] |
牛峰海, 王瑜, 任雪云, 等. 挤压脐带及延迟脐带结扎对早产儿平均血压、脑血流及新生儿神经行为测定评分的影响[J]. 吉林医学, 2016, 37(12): 2900-2902. doi: 10.3969/j.issn.1004-0412.2016.12.029
|
| [8] |
周春秀, 樊雪梅, 李六兰, 等. 不同断脐方法对胎龄低于32周早产儿循环系统的影响[J]. 护理学杂志, 2018, 33(2): 5-8. doi: 10.3870/j.issn.1001-4152.2018.02.005
|
| [9] |
KATHERIA A C, TRUONG G, COUSINS L, et al. Umbilical cord milking versus delayed cord clamping in preterm infants[J]. Pediatrics, 2015, 136(1): 61-69. doi: 10.1542/peds.2015-0368
|
| [10] |
VESOULIS Z A, LIAO S M, MATHUR A M. Delayed cord clamping is associated with improved dynamic cerebral autoregulation and decreased incidence of intraventricular hemorrhage in preterm infants[J]. J Appl Physiol, 2019, 127(1): 103-110. doi: 10.1152/japplphysiol.00049.2019
|
| [11] |
曹琳琳, 魏媛, 卢倪, 等. 挤压脐带与延迟断脐对早产儿临床效果比较的Meta分析[J]. 中国护理管理, 2020, 20(1): 78-84. doi: 10.3969/j.issn.1672-1756.2020.01.017
|
| [12] |
郭芳, 朱进秋, 罗维真, 等. 挤压脐带胎盘输血方法对极低出生体质量儿的影响[J]. 临床儿科杂志, 2015, 33(3): 211-213. doi: 10.3969/j.issn.1000-3606.2015.03.003
|
| [13] |
李光忠, 刘细萍, 罗卫娟, 等. 分娩过程中脐带挤压对早产儿脑损伤的影响[J]. 实用临床医药杂志, 2020, 24(15): 115-118. doi: 10.7619/jcmp.202015033
|
| [14] |
林玲, 彭好. 脐带延迟结扎和脐带挤压输血对早产儿脑血流动力学的影响: 一项随机双盲对照试验[J]. 中国当代儿科杂志, 2021, 23(4): 332-337. https://www.cnki.com.cn/Article/CJFDTOTAL-DDKZ202104003.htm
|
| [15] |
KATHERIA A, REISTER F, ESSERS J, et al. Association of umbilical cord milking vs delayed umbilical cord clamping with death or severe intraventricular hemorrhage among preterm infants[J]. JAMA, 2019, 322(19): 1877-1886. doi: 10.1001/jama.2019.16004
|
| [16] |
姜微微，樊雪梅，张佳华，等.脐带挤压与延迟断脐对胎龄<34周早产儿早期预后影响的Meta分析[J].中国当代儿科杂志, 2022, 24(5): 492-499.
|
| [17] |
PRATESI S, DANI C. Commentary: association of umbilical cord milking vs. delayed umbilical cord clamping with death or severe intraventricular hemorrhage among preterm infants[J]. Front Pediatr, 2020, 8: 178. doi: 10.3389/fped.2020.00178
|
| [18] |
万元, 李亚林, 汪丹丹. 有血流动力学意义的动脉导管未闭早产儿的危险因素分析[J]. 中国医药导报, 2021, 18(14): 85-88. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202114022.htm
|
| [19] |
田先雨, 陈朝红, 翟庆娜, 等. 早产儿脐带血维生素D水平与1周岁时婴儿生长发育关系的研究[J]. 中国医药科学, 2018, 8(6): 34-36, 52. doi: 10.3969/j.issn.2095-0616.2018.06.011
|
| [20] |
王晓莉, 杨琳, 沈彩琴. 延迟断脐对中晚期早产儿早期发生黄疸和颅内出血的影响[J]. 第二军医大学学报, 2021, 42(3): 338-342. https://www.cnki.com.cn/Article/CJFDTOTAL-DEJD202103018.htm
|
| [21] |
樊雪梅, 周春秀, 张爱霞, 等. 挤压脐带断脐对胎龄小于32周早产儿贫血和黄疸的影响研究[J]. 中华护理杂志, 2018, 53(2): 149-153. doi: 10.3761/j.issn.0254-1769.2018.02.004
|
© 2020 《实用临床医药杂志》编辑部
Address: 江苏省扬州市江阳中路136号，扬州大学江阳路北校区14号楼201室China Pos: 225009Tel: 0514-87978917、87978989、87978807
Supported by:
Beijing Renhe Information Technology Co., Ltd.
苏公网安备 32100302010246号
DownLoad: