Ultee C A, van der Deure J, Swart J, Lasham C, van Baar A L
Department of Paediatrics, Deventer Hospital, Deventer, The Netherlands.
Arch Dis Child Fetal Neonatal Ed. 2008 Jan;93(1):F20-3. doi: 10.1136/adc.2006.100354. Epub 2007 Feb 16.
Even mild iron deficiency and anaemia in infancy may be associated with cognitive deficits. A delay in clamping the cord improves haematocrit levels and results in greater vascular stability and less need for packed cell transfusions for anaemia in the first period after birth. Follow-up data on haemoglobin levels after the neonatal period were not available.
To provide neonatal and follow-up data for the effects of early or delayed clamping of the cord.
37 premature infants (gestational age 34 weeks, 0 days-36 weeks, 6 days) were randomly assigned to one of two groups in the first hour after birth, and at 10 weeks of age. In one group the umbilical cord was clamped within 30 seconds (mean (SD) 13.4 (5.6)) and in the other, it was clamped at 3 minutes after delivery. In the neonatal period blood glucose and haemoglobin levels were determined. At 10 weeks of age haemoglobin and ferritin levels were determined.
The late cord-clamped group showed consistently higher haemoglobin levels than the early cord-clamped group, both at the age of 1 hour (mean (SD) 13.4 (1.9) mmol/l vs 11.1 (1.7) mmol/l), and at 10 weeks (6.7 (0.75) mmol/l vs 6.0 (0.65) mmol/l). No relationship between delayed clamping of the umbilical cord and pathological jaundice or polycythaemia was found.
Immediate clamping of the umbilical cord should be discouraged.
婴儿期即使是轻度缺铁和贫血也可能与认知缺陷有关。延迟钳夹脐带可提高血细胞比容水平，并在出生后的第一阶段带来更大的血管稳定性，减少因贫血而进行红细胞输注的需求。但新生儿期后血红蛋白水平的随访数据尚不可得。
提供脐带早夹或晚夹效果的新生儿期及随访数据。
37名早产儿（胎龄34周0天至36周6天）在出生后1小时内及10周龄时被随机分为两组。一组在30秒内（平均（标准差）13.4（5.6）秒）钳夹脐带，另一组在分娩后3分钟钳夹脐带。在新生儿期测定血糖和血红蛋白水平。在10周龄时测定血红蛋白和铁蛋白水平。
晚夹脐带组在1小时龄（平均（标准差）13.4（1.9）mmol/L对11.1（1.7）mmol/L）和10周龄（6.7（0.75）mmol/L对6.0（0.65）mmol/L）时的血红蛋白水平始终高于早夹脐带组。未发现延迟钳夹脐带与病理性黄疸或红细胞增多症之间存在关联。
应不鼓励立即钳夹脐带。
