Indraccolo U, Santafata R, Palazzetti P L, Di Iorio R, Indraccolo S R
Complex Operative Unit of Gynecology and Obstetrics of Civitanova Marche, Hospital of Civitanova Marche, Italy.
Department of Gynecological, Obstetrical, and Urological Sciences, "La Sapienza" University of Rome, Italy.
Clin Exp Obstet Gynecol. 2013;40(4):557-60.
To date, delaying cord clamping two to three minutes after birth is considered effective for newborn well-being. This time does not consider the newborn's breathing movements, which may also condition neonate well-being.
To investigate the behaviour of neonatal weight loss and of some umbilical vein lab parameters, in relation to timing of newborn breathing and cord clamping.
Time from birth to cord clamping and time from birth to first cry of the newborn were collected in 87 full-term healthy women. First cry is a sign of effective breathing. Birth weight loss at the first, second, and third day from birth and lab parameters were assessed in relation to: time from birth to cord clamping, time from birth to first cry, and cord clamping before or after the first cry.
Partial pressure of carbon dioxide (pCO2) decreased if cord clamping was performed after first cry and increased if first cry occurred after cord clamping, independently from the time elapsed from birth to first cry (p = 0.012). Calcium (Ca(2+)) concentration decreased if cord clamping was performed after the first cry and increased if first cry of the baby after birth was delayed (p = 0.021). Each second of delay from birth to cord clamping resulted in an increase in Cl- concentration (p <0.001). Each second of delay in cord clamping resulted in a reduction in the percentage of weight loss at the first day (p = 0.024), at the second day (p = 0.007), and at the third day (p = 0.028) after birth.
Neonate breathing after birth should induce umbilical vein flow from placenta to lungs, conditioning the reduction of birth weight loss after birth and umbilical lab parameters modifications.
迄今为止，出生后延迟两到三分钟钳夹脐带被认为对新生儿健康有效。这个时间并未考虑新生儿的呼吸运动，而呼吸运动也可能影响新生儿的健康状况。
研究新生儿体重减轻情况及一些脐静脉实验室参数与新生儿呼吸和脐带钳夹时间的关系。
收集了87名足月健康产妇从出生到脐带钳夹的时间以及从出生到新生儿第一次啼哭的时间。第一次啼哭是有效呼吸的标志。评估出生后第一天、第二天和第三天的体重减轻情况以及实验室参数与以下因素的关系：从出生到脐带钳夹的时间、从出生到第一次啼哭的时间，以及第一次啼哭之前或之后的脐带钳夹情况。
如果在第一次啼哭后进行脐带钳夹，二氧化碳分压（pCO2）会降低；如果第一次啼哭发生在脐带钳夹之后，则二氧化碳分压会升高，且与从出生到第一次啼哭所经过的时间无关（p = 0.012）。如果在第一次啼哭后进行脐带钳夹，钙（Ca(2+)）浓度会降低；如果出生后新生儿第一次啼哭延迟，则钙浓度会升高（p = 0.021）。从出生到脐带钳夹每延迟一秒，氯离子（Cl-）浓度就会升高（p <0.001）。脐带钳夹每延迟一秒，出生后第一天（p = 0.024）、第二天（p = 0.007）和第三天（p = 0.028）的体重减轻百分比就会降低。
出生后新生儿呼吸应促使脐静脉血流从胎盘流向肺部，从而减少出生后体重减轻并改变脐带实验室参数。
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