Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey.
Division of Neonatology, Department of Pediatrics, Yildirim Beyazit University Hospital, Ankara, Turkey.
Am J Perinatol. 2022 Nov;39(15):1682-1687. doi: 10.1055/s-0041-1726035. Epub 2021 Mar 3.
The average time for umbilical cord separation in term neonates is 7 to 10 days. Prematurity, phototherapy, prolonged duration of antibiotic treatment, and parenteral nutrition are other factors which were demonstrated to delay cord separation. In the previous studies including greater premature infants, the time of separation of the umbilical cord was shown to vary 2 to 3 weeks. We aimed to determine the cord separation time and associated factors in very-low-birth-weight (VLBW) infants.
In this retrospective study, VLBW infants (birth weight [BW] <1,500 g, gestational age [GA] < 32 weeks) without umbilical catheterization were included. Specific cord care was not applied. The cord separation time, gender, mode of delivery, presence of sepsis, duration of antibiotic treatment, serum free thyroxine, free triiodothyronine (FT3), thyroid-stimulating hormone, lowest leukocyte, polymorphonuclear leukocytes (PMNLs), and platelet counts were recorded.
The study included 130 infants (GA: 29 ± 2 weeks, BW: 1,196 ± 243 g). Mean cord separation time was 14 ± 5 days, while 95th percentile was 22nd day of life. A positive correlation was demonstrated between duration of antibiotic treatment and cord separation time ( < 0.001, : 0.505). Cord separation time did not differ regarding gender or mode of delivery. Corrected leukocyte count ( = 0.031, : -0.190) and PMNL count ( = 0.022, : -0.201), and serum FT3 level ( = 0.003, : -0.261) were found to be negatively correlated with cord separation time. The cord separation time was found to be delayed in the presence of sepsis (with sepsis: 18 ± 7 days and without sepsis: 13 ± 3 days; = 0.008). Sepsis was found to delay the cord separation time beyond second week (odds ratio = 6.30 [95% confidence interval: 2.37-15.62], < 0.001).
The 95th percentile for cord separation time was 22nd day. Sepsis might be either the reason or the consequence of delayed cord detachment. The exact contribution of low serum FT3 levels to the process of cord separation should be investigated in further studies.
· Mean cord separation time was 14 ± 5 days, while 95th percentile was 22nd day, in VLBW infants.. · Sepsis was found to delay the cord separation time by sixfold beyond second week.. · Serum free triiodothyronine level was negatively correlated with cord separation time..
足月新生儿脐带分离的平均时间为 7 至 10 天。早产儿、光疗、抗生素治疗时间延长和肠外营养等因素被证明会延迟脐带分离。在包括更大早产儿的先前研究中，脐带分离的时间差异为 2 至 3 周。我们旨在确定极低出生体重（VLBW）婴儿的脐带分离时间和相关因素。
在这项回顾性研究中，纳入了无脐尿管的 VLBW 婴儿（出生体重[BW] <1,500 g，胎龄[GA] <32 周）。未应用特定的脐带护理。记录脐带分离时间、性别、分娩方式、败血症、抗生素治疗时间、血清游离甲状腺素、游离三碘甲状腺原氨酸（FT3）、促甲状腺激素、最低白细胞、多形核白细胞（PMN）和血小板计数。
研究纳入了 130 名婴儿（GA：29±2 周，BW：1,196±243 g）。平均脐带分离时间为 14±5 天，第 95 百分位数为第 22 天。抗生素治疗时间与脐带分离时间呈正相关（ < 0.001，：0.505）。性别或分娩方式与脐带分离时间无差异。校正后的白细胞计数（ = 0.031，：-0.190）和 PMNL 计数（ = 0.022，：-0.201）以及血清 FT3 水平（ = 0.003，：-0.261）与脐带分离时间呈负相关。败血症患者的脐带分离时间延迟（败血症：18±7 天，无败血症：13±3 天； = 0.008）。败血症使脐带分离时间延迟至第二周后（比值比 = 6.30 [95%置信区间：2.37-15.62]， < 0.001）。
脐带分离时间的第 95 百分位数为第 22 天。败血症可能是脐带分离延迟的原因或结果。低血清 FT3 水平对脐带分离过程的确切贡献应在进一步研究中进行调查。
· VLBW 婴儿的平均脐带分离时间为 14±5 天，第 95 百分位数为第 22 天。· 败血症使脐带分离时间延迟六倍，超过第二周。· 血清游离三碘甲状腺原氨酸水平与脐带分离时间呈负相关。
