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延迟脐带夹闭对接受晚期早产儿产前皮质类固醇治疗的 34-36 周新生儿血糖水平的影响。

The effect of delayed cord clamping on blood sugar levels on 34-36 week neonates exposed to late preterm antenatal steroids.

机构信息

Children's National Health System, Prenatal Pediatric Institute, Washington, DC, USA.

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Inova Health Systems, Falls Church, VA, USA.

出版信息

J Matern Fetal Neonatal Med. 2022 Sep;35(18):3587-3594. doi: 10.1080/14767058.2020.1832074. Epub 2020 Oct 12.

DOI:10.1080/14767058.2020.1832074
PMID:33043779
Abstract

OBJECTIVE

Neonatal hypoglycemia is a known side effect of antenatal betamethasone (BMZ) given for fetal maturation. We sought to investigate if delayed cord clamping (DCC) has an impact on neonatal hypoglycemia induced by antenatal late preterm BMZ administration.

MATERIAL AND METHODS

Retrospective cohort study (January 2019-May 2019) of pregnancies undergoing delivery at 34-0/7 to 36-6/7 weeks at a single center included in two groups: DCC + BMZ and BMZ-only (no DCC). The primary outcome was the occurrence of neonatal hypoglycemia at the first hour after delivery.

RESULTS

A total of 62/188, 32.98% (DCC + BMZ group) and 45/100, 45% (DCC-only group) infants presented with hypoglycemia at 1-h after birth (adjusted  = .06; OR 0.73, 95% CI 0.54-1.01). When stratified according to gestational age at delivery, DCC was associated with a 46% reduction in the occurrence of neonatal hypoglycemia among those born at 35-0/7 to 35-6/7 weeks (adjusted  = .033; OR 0.54, 95% CI 0.33-0.88) and 35% reduction among those born at 36-0/7 to 36-67 weeks (adjusted  = .046; OR 0.65, 95% CI 0.43-0.97).

CONCLUSION

In our cohort, delayed cord clamping in infants receiving late preterm BMZ born between 35-0/7 and 36-6/7 weeks' gestation protects from early neonatal hypoglycemia.

摘要

目的

产前使用倍他米松(BMZ)促进胎儿成熟会导致新生儿低血糖,这是已知的副作用。我们旨在研究延迟脐带夹闭(DCC)是否会对产前晚期早产 BMZ 给药引起的新生儿低血糖产生影响。

材料和方法

这是一项单中心回顾性队列研究(2019 年 1 月至 2019 年 5 月),纳入在 34-0/7 至 36-6/7 周分娩的妊娠患者,分为两组:DCC+BMZ 和仅 BMZ(无 DCC)。主要结局是在分娩后 1 小时内新生儿低血糖的发生情况。

结果

共有 62/188(DCC+BMZ 组)和 45/100(DCC 组)婴儿在出生后 1 小时出现低血糖,校正后  = .06;OR 0.73,95%CI 0.54-1.01)。根据分娩时的胎龄分层,DCC 与 35-0/7 至 35-6/7 周出生的新生儿低血糖发生率降低 46%相关(校正后  = .033;OR 0.54,95%CI 0.33-0.88),36-0/7 至 36-67 周出生的新生儿低血糖发生率降低 35%(校正后  = .046;OR 0.65,95%CI 0.43-0.97)。

结论

在我们的队列中,在接受晚期早产 BMZ 治疗的婴儿中延迟脐带夹闭可预防 35-0/7 至 36-6/7 周出生的新生儿早期低血糖。

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