延迟脐带夹闭与极低出生体重儿的急性肾损伤无关。
Delayed Umbilical Cord Clamping is Not Associated with Acute Kidney Injury in Very Low Birth Weight Neonates.
机构信息
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia.
出版信息
Am J Perinatol. 2020 Jan;37(2):210-215. doi: 10.1055/s-0039-1697671. Epub 2019 Oct 13.
OBJECTIVE
This study aimed to determine if delayed cord clamping (DCC) is associated with a reduction in neonatal acute kidney injury (AKI).
STUDY DESIGN
A retrospective single-center cohort study of 278 very low birth weight (VLBW) neonates was performed to compare the incidence of AKI in the following groups: immediate cord clamping (ICC), DCC, and umbilical cord milking. AKI was diagnosed by the modified neonatal Kidney Diseases and Improving Global Outcomes (KDIGO) definition.
RESULTS
The incidence of AKI in the first week was 20.1% with no difference between groups ( = 0.78). After adjustment for potential confounders, the odds of developing AKI, following DCC, compared with ICC was 0.93 (confidence interval [CI]: 0.46-1.86) with no reduction in the stage of AKI between groups.
CONCLUSION
In this study, DCC was not associated with a reduced rate of AKI in VLBW neonates. However, the data suggest that DCC is also not harmful to the kidneys, further supporting the safety of DCC in VLBW neonates.
目的
本研究旨在确定延迟脐带夹闭（DCC）是否与新生儿急性肾损伤（AKI）的减少有关。
研究设计
对 278 例极低出生体重（VLBW）新生儿进行回顾性单中心队列研究，以比较以下各组新生儿 AKI 的发生率：即刻脐带夹闭（ICC）、DCC 和脐带挤奶。AKI 的诊断采用改良的新生儿肾脏病和改善全球结局（KDIGO）定义。
结果
第 1 周 AKI 的发生率为 20.1%，各组之间无差异（=0.78）。在调整了潜在混杂因素后，与 ICC 相比，DCC 后发生 AKI 的优势比为 0.93（95%置信区间：0.46-1.86），两组之间 AKI 的分期无差异。
结论
在这项研究中，DCC 与 VLBW 新生儿 AKI 发生率的降低无关。然而，数据表明 DCC 对肾脏也没有危害，进一步支持 DCC 在 VLBW 新生儿中的安全性。
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