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对于正常风险的妊娠,延迟脐带结扎不会增加黄疸发生率及光疗需求。

Late umbilical cord clamping does not increase rates of jaundice and the need for phototherapy in pregnancies at normal risk.

作者信息

Carvalho Ocília Maria Costa, Augusto Matheus Costa Carvalho, Medeiros Maxsuênia Queiroz, Lima Hesly Martins Pereira, Viana Junior Antonio Brazil, Araujo Júnior Edward, Carvalho Francisco Herlânio Costa

机构信息

a Assis Chateaubriand Maternity School , Federal University of Ceará (UFC), Council of Europe , Fortaleza , Brazil.

b Department of Maternal and Child , Federal University of Ceará (UFC), Council of Europe , Fortaleza , Brazil.

出版信息

J Matern Fetal Neonatal Med. 2019 Nov;32(22):3824-3829. doi: 10.1080/14767058.2018.1473367. Epub 2018 May 17.

Abstract

To verify the relationship between the time of clamping of the umbilical cord and the development of neonatal jaundice, the dosage of bilirubin and the need for phototherapy. Cross-sectional, retrospective study with 398 parturients at normal risk (single term gestation, no complications during gestation or delivery, birth weight between 2500 and 4499 g). The population was divided into three groups regarding the time of cord clamping: <1 min(117, 29.4%), between 1 and 3 min(228, 57.3%) and >3 min(53, 13.3%). Sociodemographic, clinical and obstetric characteristics, birth and delivery data, and maternal and perinatal outcomes were evaluated. Pearson's chi-square test, Fisher's exact test and the Kruskal-Wallis test were used for comparison between the groups. Statistical significance was considered  < .05. The groups were similar in the development of jaundice ( = .370), bilirubin dosage ( = .342) and need for phototherapy ( = .515). Late clamping was more prevalent in vaginal deliveries when compared to cesarean sections (1-3 min: 64 versus 21.4%, >3 min: 16.6 versus 1%) ( < .001). There was no difference in other maternal or perinatal variables. The clamping time of the umbilical cord showed no association with jaundice, bilirubin dosage, or phototherapy needs in neonates at normal risk. The adoption of late clamping was more prevalent in vaginal deliveries.

摘要

为验证脐带夹闭时间与新生儿黄疸发生、胆红素剂量及光疗需求之间的关系。对398例正常风险产妇(单胎足月妊娠,妊娠期或分娩期无并发症,出生体重在2500至4499克之间)进行横断面回顾性研究。根据脐带夹闭时间将人群分为三组:<1分钟(117例,29.4%)、1至3分钟(228例,57.3%)和>3分钟(53例,13.3%)。评估社会人口统计学、临床和产科特征、出生和分娩数据以及母婴和围产期结局。采用Pearson卡方检验、Fisher精确检验和Kruskal-Wallis检验进行组间比较。统计学显著性设定为<0.05。三组在黄疸发生情况(P = 0.370)、胆红素剂量(P = 0.342)和光疗需求(P = 0.515)方面相似。与剖宫产相比延迟夹闭在阴道分娩中更常见(1至3分钟:64%对21.4%,>3分钟:16.6%对1%)(P < 0.001)。其他母婴或围产期变量无差异。正常风险新生儿的脐带夹闭时间与黄疸、胆红素剂量或光疗需求无关。延迟夹闭在阴道分娩中更常见。

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