Salari Z, Rezapour M, Khalili N
Department of Obstetrics and Gynecology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
General Practitioner, Kerman University of Medical Sciences, Kerman, Iran.
J Neonatal Perinatal Med. 2014;7(4):287-91. doi: 10.3233/NPM-1463913.
Based on current evidence, there is a little agreement on the best timing for after birth umbilical cord clamping. This study was designed to compare the impact of using two different times for cord clamping on hematocrit concentration and Apgar scores of the neonate.
Fifty-six healthy full-term vaginally born neonates were allocated to early (10 seconds after delivery) and late (3 minutes after delivery) umbilical cord clamping groups in this randomized clinical trial. We recorded the length of the 3rd stage of labor and Apgar score at 5 minutes. Infant's hematocrit was measured at 2 and 18 hours of age.
Neonatal hematocrit differed between the two groups. Late cord clamping group had greater hematocrit at 2 hours (45.5 ± 4 vs. 49.5 ± 4.4, P = 0.0003) and 18 hours (47.7 ± 5.5 vs. 52.9 ± 4.3, P = 0.0002). Apgar scores at 5 minutes (9.3 ± 0.6 vs. 9.4 ± 0.6, p = 0.5) and duration of delivery 3rd stage (10.2 ± 3.7 min vs. 8.9 ± 5 min, P = 0.2) did not differ between early and late cord clamping groups respectively.
Late cord clamping leads to a significant increase in the hematocrit of the neonate but it does not have effects on Apgar score and duration of the 3rd stage of labor.
基于当前证据，对于出生后脐带结扎的最佳时机，人们几乎没有达成共识。本研究旨在比较两种不同脐带结扎时间对新生儿血细胞比容浓度和阿氏评分的影响。
在这项随机临床试验中，56名健康的足月阴道分娩新生儿被分配到早期（分娩后10秒）和晚期（分娩后3分钟）脐带结扎组。我们记录了第三产程的时长以及5分钟时的阿氏评分。在婴儿2小时和18小时大时测量其血细胞比容。
两组新生儿的血细胞比容存在差异。晚期脐带结扎组在2小时时的血细胞比容更高（45.5±4对49.5±4.4，P = 0.0003），在18小时时也是如此（47.7±5.5对52.9±4.3，P = 0.0002）。早期和晚期脐带结扎组5分钟时的阿氏评分（9.3±0.6对9.4±0.6，p = 0.5）以及第三产程的时长（10.2±3.7分钟对8.9±5分钟，P = 0.2）分别无差异。
晚期脐带结扎会导致新生儿血细胞比容显著升高，但对阿氏评分和第三产程时长没有影响。
