Division of Neonatology, General and University Hospital, Castellon, Spain.
Division of Obstetrics and Gynecology, General and University Hospital, Castellon, Spain.
J Perinatol. 2019 Apr;39(4):547-553. doi: 10.1038/s41372-019-0329-6. Epub 2019 Feb 5.
Intraventricular hemorrhage (IVH) is a common complication in extremely preterm infants. We aimed to demonstrate that umbilical cord milking (UCM) would reduce the incidence of IVH in this at risk population.
We compared the incidence of IVH in a prospective cohort of consecutively born preterm infants <32 weeks' gestation receiving UCM (n = 33) with a historical cohort that underwent immediate cord clamping (ICC) (n = 36).
No significant differences regarding perinatal characteristics were present between both groups except for chorioamnionitis and preterm rupture of membranes which were more frequent in the UCM group. There was a significant reduction in the incidence of IVH in the UCM group as compared to the ICC group (UCM vs. ICC = 12 vs. 33%, p = 0.037; OR = 0.276 (95% CI 0.079-0.967; p = 0.033; NNT = 4.7) and a reduction in the number of transfusions (UCM vs. ICC = 56 vs. 30%, p = 0.035; OR = 0.348 (0.129-0.938; p = 0.033; NNT = 3.8). UCM was safe for mothers (similar decrease in maternal hemoglobin) and offspring.
UCM significantly reduced the incidence of IVH in preterm infants < 32 weeks' gestation without associated complications for mother or offspring.
脑室内出血（IVH）是极早产儿的常见并发症。本研究旨在证明脐带挤血（UCM）可降低高危早产儿 IVH 的发生率。
我们比较了连续出生的<32 周胎龄早产儿中接受 UCM（n=33）与立即断脐（ICC）（n=36）的前瞻性队列的 IVH 发生率。
两组间围产期特征无显著差异，除 UCM 组的绒毛膜羊膜炎和胎膜早破更为常见外。与 ICC 组相比，UCM 组 IVH 的发生率显著降低（UCM 与 ICC 分别为 12%与 33%，p=0.037；OR=0.276（95%CI 0.079-0.967；p=0.033；NNH=4.7）和输血次数减少（UCM 与 ICC 分别为 56%与 30%，p=0.035；OR=0.348（0.129-0.938；p=0.033；NNH=3.8）。UCM 对母亲（母亲血红蛋白相似下降）和后代是安全的。
UCM 可显著降低<32 周胎龄早产儿 IVH 的发生率，而不增加母婴并发症。
