24至32周出生婴儿的即刻和延迟脐带结扎：一项试点随机对照试验。
Immediate and delayed cord clamping in infants born between 24 and 32 weeks: a pilot randomized controlled trial.
作者信息
Mercer Judith S, McGrath Margaret M, Hensman Angelita, Silver Helayne, Oh William
机构信息
College of Nursing, University of Rhode Island, White Hall, 2 Heathman Road, Kingston, RI 02881-2021, USA.
出版信息
J Perinatol. 2003 Sep;23(6):466-72. doi: 10.1038/sj.jp.7210970.
OBJECTIVE
This pilot study's aim was to establish feasibility of a protocol for delayed cord clamping (DCC) versus immediate cord clamping (ICC) at preterm birth and to examine its effects on initial blood pressure and other outcomes.
STUDY DESIGN
A randomized controlled trial recruited 32 infants between 24 and 32 weeks. Immediately before delivery, mothers were randomized to ICC (cord clamped at 5 to 10 seconds) or DCC (30- to 45-second delay in cord clamping) groups.
RESULTS
Intention-to-treat analyses revealed that the DCC group were more likely to have higher initial mean blood pressures (adjusted OR 3.4) and less likely to be discharged on oxygen (adjusted OR 8.6). DCC group infants had higher initial glucose levels (ICC=36 mg/dl, DCC=73.1 mg/dl; p=0.02).
CONCLUSION
The research design is feasible. The immediate benefit of improved blood pressure was confirmed and other findings deserve consideration for further study.
目的
这项初步研究的目的是确定早产时延迟脐带结扎（DCC）与立即脐带结扎（ICC）方案的可行性，并研究其对初始血压和其他结局的影响。
研究设计
一项随机对照试验招募了32名孕周在24至32周之间的婴儿。在分娩前，母亲被随机分为ICC组（脐带在5至10秒时结扎）或DCC组（脐带结扎延迟30至45秒）。
结果
意向性分析显示，DCC组更有可能具有较高的初始平均血压（调整后的OR为3.4），且吸氧出院的可能性较小（调整后的OR为8.6）。DCC组婴儿的初始血糖水平较高（ICC = 36mg/dl，DCC = 73.1mg/dl；p = 0.02）。
结论
该研究设计是可行的。改善血压的即时益处得到了证实，其他研究结果值得进一步研究考虑。
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