Department of Neonatology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Divisions of Neonatology and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Am J Perinatol. 2022 Jul;39(9):1015-1019. doi: 10.1055/s-0040-1721494. Epub 2020 Dec 7.
Despite known benefits, the timing of and method used for umbilical cord clamping (UCC) in neonates remain controversial in China, as well as internationally. The objective of this study was to assess knowledge, attitudes, and practice of UCC amongst health care providers in China, as recommended by medical professional organizations.
A web-based questionnaire on cord clamping practices was administered to midwives, obstetricians, and neonatologists in 126 hospitals from 16 provinces. The provinces were selected from seven different regions of China.
A total of 5,005 (60.5% of eligible respondents) health care providers returned completed questionnaires. The awareness rates for immediate cord clamping (ICC) and delayed cord clamping (DCC) were over 85%, but the implementation rate for DCC was relatively low (ICC 58.3% vs. DCC 41.6%). Most neonates were placed below the introitus (92.8%) during cord clamping and this correlated with the route of delivery. The choice of UCC was impelled by different factors. Benefits for neonates influenced the choice of ICC (50%) and promoting a larger blood volume to stabilize systemic circulation influenced the choice of DCC (92.3%). Majority (91.5%) of respondents acquiesced that it was necessary to develop national clinical guidelines for UCC.
The majority of obstetricians, neonatologists, and midwives who participated in this study had a positive perception of DCC. However, this did not translate to daily practice. The practice of UCC is variable and there are no standard guidelines.
· The first large-scale epidemiological investigation of umbilical cord ligation is in China.. · The survey included three commonly used umbilical cord clamping methods.. · The respondents included neonatologists..
尽管已知其益处，但在中国乃至国际上，新生儿脐带夹闭（UCC）的时机和方法仍存在争议。本研究旨在评估中国医疗保健提供者在脐带夹闭方面的知识、态度和实践，这是医学专业组织推荐的。
对来自中国 16 个省的 126 家医院的助产士、产科医生和新生儿科医生进行了一项关于脐带夹闭实践的网络问卷调查。这些省份选自中国七个不同的地区。
共有 5005 名（合格受访者的 60.5%）医疗保健提供者返回了完整的问卷。立即夹闭（ICC）和延迟夹闭（DCC）的知晓率均超过 85%，但 DCC 的实施率相对较低（ICC 为 58.3%，DCC 为 41.6%）。大多数新生儿在脐带夹闭时被放在入口下方（92.8%），这与分娩方式有关。UCC 的选择受到不同因素的影响。新生儿的益处影响 ICC 的选择（50%），促进更大的血量以稳定全身循环影响 DCC 的选择（92.3%）。大多数（91.5%）受访者认为有必要制定国家 UCC 临床指南。
参加这项研究的大多数产科医生、新生儿科医生和助产士对 DCC 有积极的看法。然而，这并没有转化为日常实践。UCC 的实践是可变的，没有标准的指南。
· 这是中国首次大规模的脐带结扎流行病学调查。· 该调查包括三种常用的脐带夹闭方法。· 受访者包括新生儿科医生。
