Clinical Significance of Delayed Cord Clamping in Very Preterm Infants

doi:10.12280/gjfckx.20211089

Abstract

Abstract:

Objective：To evaluate the effects of delayed umbilical cord clamping methods on the prognosis of very preterm infants. Methods：Very preterm infants delivered vaginally in the Third Affiliated Hospital of Zhengzhou University from May 2019 to May 2021 were randomly divided into early cord clamping (ECC) group of 67 cases and delayed cord clamping (DCC) group of 63 cases. The occurrence rate of blood routine、bilirubin value, Apgar score, mean arterial pressure, blood gas, neonatal hypoxemia, acute respiratory distress syndrome (ARDS), blood transfusion, intraventricular hemorrhage, necrotizing enteritis, sepsis, hypoglycemia, neonatal death, hyperbilirubinemia and phototherapy were compared between the two groups. The average hospitalization days and average hospitalization expenses of very preterm infants in the two groups were compared, and the third stage of labor and postpartum hemorrhage of the two groups were compared. Results：The birth hemoglobin, 72 hour hemoglobin, birth hematocrit, 72 hour hematocrit, birth mean arterial pressure, birth bilirubin value and peak bilirubin of premature infants in DCC group were higher than those in ECC group (P<0.05). The incidence of hypoxemia, ARDS, blood transfusion, intraventricular hemorrhage, necrotizing enteritis, sepsis, hypoglycemia, average hospitalization days and average hospitalization expenses of very preterm infants in DCC group were lower than those in ECC group (P<0.05). There was no significant difference in Apgar score, body temperature, incidence of neonatal acidosis, incidence of hyperbilirubinemia, incidence of phototherapy, incidence of polycythemia and newborn mortality between the two groups (P>0.05). There was no significant difference in the third stage of labor and postpartum hemorrhage between the two groups (P>0.05). Conclusions：Delayed cord clamping is a clinical intervention that can effectively improve the delivery outcome of very preterm infants without increasing other complications.

Key words: Umbilical cord, Ligation, Placenta, Infant, premature, Complications, Prognosis

SHI Wei, XU Yi-ming, WANG Jun-nai, HU Meng-cai. Clinical Significance of Delayed Cord Clamping in Very Preterm Infants[J]. Journal of International Obstetrics and Gynecology, 2022, 49(4): 434-438.

Figures/Tables 5

References 20

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组别	n	孕妇年龄（岁）	胎龄（周）	新生儿体质量（g）
DCC组	63	29.59±4.60	29.97±0.98	1 817.30±466.48
ECC组	67	29.04±3.61	30.29±0.96	1 856.72±412.35
t		0.751	-1.907	-0.511
P		0.454	0.059	0.610

组别	n	孕妇年龄（岁）	胎龄（周）	新生儿体质量（g）
DCC组	63	29.59±4.60	29.97±0.98	1 817.30±466.48
ECC组	67	29.04±3.61	30.29±0.96	1 856.72±412.35
t		0.751	-1.907	-0.511
P		0.454	0.059	0.610

组别	n	1 min Apgar 评分	5 min Apgar 评分	平均动脉压（mmHg）	体温（℃）
DCC组	63	9.00±1.49	9.63±0.70	49.18±3.84	36.57±0.15
ECC组	67	8.66±1.21	9.40±0.70	44.00±2.46	36.53±0.16
t		1.443	1.888	9.095	1.812
P		0.151	0.061	<0.001	0.072

组别	n	1 min Apgar 评分	5 min Apgar 评分	平均动脉压（mmHg）	体温（℃）
DCC组	63	9.00±1.49	9.63±0.70	49.18±3.84	36.57±0.15
ECC组	67	8.66±1.21	9.40±0.70	44.00±2.46	36.53±0.16
t		1.443	1.888	9.095	1.812
P		0.151	0.061	<0.001	0.072

组别	n	产妇第三产程（min）	产妇产后出血量（mL）	极早产儿平均住院日（d）	极早产儿平均住院费用（元）
DCC组	63	7.00（6.00,9.00）	180.00（170.00,230.00）	12.00（9.00,21.50）	21 654.00（12 790.00,45 290.50）
ECC组	67	8.00（5.50,11.00）	190.00（180.00,230.00）	21.00（13.50,39.50）	47 470.00（27 114.00,86 436.50）
Z		-1.217	-0.786	-3.785	-4.353
P		0.224	0.432	<0.001	<0.001