早产时夹闭脐带（CUPiD）研究：在一项随机对照试验中，对胎龄<32 周的早产儿在新生儿即刻期进行神经监测。
Clamping the Umbilical Cord in Premature Deliveries (CUPiD): Neuromonitoring in the Immediate Newborn Period in a Randomized, Controlled Trial of Preterm Infants Born at <32 Weeks of Gestation.
机构信息
Department of Pediatrics and Child Health, Cork University Maternity Hospital, Cork Ireland; Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland.
Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland; Department of Obstetrics, Cork University Maternity Hospital, Cork Ireland.
出版信息
J Pediatr. 2019 May;208:121-126.e2. doi: 10.1016/j.jpeds.2018.12.039. Epub 2019 Mar 14.
OBJECTIVE
To compare cerebral activity and oxygenation in preterm infants (<32 weeks of gestation) randomized to different cord clamping strategies.
STUDY DESIGN
Preterm infants born at <32 weeks of gestation were randomized to immediate cord clamping, umbilical cord milking (cord stripped 3 times), or delayed cord clamping for 60 seconds with bedside resuscitation. All infants underwent electroencephalogram (EEG) and cerebral near infrared spectroscopy for the first 72 hours after birth. Neonatal primary outcome measures were quantitative measures of the EEG (17 features) and near infrared spectroscopy over 1-hour time frames at 6 and 12 hours of life.
RESULTS
Forty-five infants were recruited during the study period. Twelve infants (27%) were randomized to immediate cord clamping, 19 (42%) to umbilical cord milking, and 14 (31%) to delayed cord clamping with bedside resuscitation. There were no significant differences between groups for measures of EEG activity or cerebral near infrared spectroscopy. Three of the 45 infants (6.7%) were diagnosed with severe IVH (2 in the immediate cord clamping group, 1 in the umbilical cord milking group; P = .35).
CONCLUSIONS
There were no differences in cerebral EEG activity and cerebral oxygenation values between cord management strategies at 6 and 12 hours.
TRIAL REGISTRATION
ISRCTN92719670.
目的
比较随机分组的不同断脐策略对早产儿（<32 孕周）脑活动和氧合的影响。
研究设计
本研究纳入了出生时<32 孕周的早产儿，随机分为即刻断脐组、脐带挤奶组（3 次挤脐带）或延迟断脐组（60 秒，床边复苏）。所有婴儿在出生后 72 小时内行脑电图（EEG）和脑近红外光谱检查。新生儿的主要结局指标为出生后 6 小时和 12 小时的 1 小时内 EEG（17 项特征）和近红外光谱定量测量。
结果
研究期间共纳入 45 例婴儿。12 例（27%）婴儿随机分至即刻断脐组，19 例（42%）婴儿分至脐带挤奶组，14 例（31%）婴儿分至延迟断脐+床边复苏组。三组间的 EEG 活动或脑近红外光谱测量均无显著差异。45 例婴儿中有 3 例（6.7%）被诊断为严重 IVH（即刻断脐组 2 例，脐带挤奶组 1 例；P=0.35）。
结论
6 小时和 12 小时时，不同断脐策略对大脑 EEG 活动和脑氧合值无影响。
试验注册
ISRCTN92719670。
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