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脐带夹闭时机对新生儿铁状态的影响及其与分娩方式的关系。

Effect of timing of umbilical cord clamp on newborns' iron status and its relation to delivery type.

机构信息

Pediatric Infections Research Center, Department of Pediatrics, Shaheed Beheshti University of Medical Sciences and Health Services, Tehran, Iran.

出版信息

Arch Iran Med. 2010 Sep;13(5):420-5.

Abstract

OBJECTIVE

This study was conducted to evaluate the hematological effects of umbilical cord clamp timing and delivery type in term infants 48 hours after birth in Imam Hossein Hospital, Tehran, Iran.

METHOD

From Oct 2007 - March 2008, 100 mother-infant eligible pairs were selected and divided by cord clamp timing (< or =15 s and >15 s) for hematologic value determination between the two groups. Data analysis was performed with SPSS for Windows statistical package (version 13).

RESULTS

Maternal hematological status was assessed upon admission to the delivery room. A total of 100 mother-infant pairs were divided into two groups: delayed cord clamp time within 15 s (n=70) or early cord clamp time [15 s after delivery (n=30)]. The groups had similar demographic and biomedical characteristics at baseline. Forty-eight hours after delivery the mean infant hemoglobin (Hgb; 16.08 gm/dL vs. 14.5 gm/dL; P<0.001) and hematocrit (Hct 47.6 vs. 42.8; P<0.001) levels were significantly higher in the delayed clamping group. There was no significant difference in ferritin levels (214.7 vs. 173.6 ng/dL; P=0.08). Fifty infants were born vaginally and 50 were delivered by cesarean section. Infants delivered vaginally had significantly more delayed cord clamp times (>15 s; P<0.001).

CONCLUSION

Delaying cord clamping increases the red cell mass in term infants. It is a safe, simple and low cost delivery procedure that should be incorporated in integrated programs that are aimed at reducing iron deficiency anemia in infants in developing countries. Vaginal delivery facilitates this action.

摘要

目的

本研究旨在评估伊朗德黑兰伊玛目侯赛因医院足月婴儿出生后 48 小时内断脐时机和分娩方式对其血液学的影响。

方法

2007 年 10 月至 2008 年 3 月,选择了 100 对符合条件的母婴,根据断脐时间(<或=15 秒和>15 秒)将其分为两组,以确定两组之间的血液学值。数据分析采用 SPSS for Windows 统计软件包(版本 13)。

结果

产妇在进入分娩室时评估其血液学状态。总共将 100 对母婴分为两组:延迟断脐时间<15 秒(n=70)或早期断脐时间[分娩后 15 秒内(n=30)]。两组在基线时具有相似的人口统计学和生物医学特征。出生后 48 小时,延迟夹闭组婴儿血红蛋白(Hgb;16.08 gm/dL 比 14.5 gm/dL;P<0.001)和红细胞压积(Hct 47.6 比 42.8;P<0.001)水平显著升高。铁蛋白水平无显著差异(214.7 比 173.6 ng/dL;P=0.08)。50 名婴儿经阴道分娩,50 名经剖宫产分娩。经阴道分娩的婴儿有明显更长的延迟夹闭时间(>15 秒;P<0.001)。

结论

延迟断脐可增加足月婴儿的红细胞量。这是一种安全、简单、低成本的分娩方式,应纳入旨在减少发展中国家婴儿缺铁性贫血的综合方案中。阴道分娩有利于实施该操作。

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