Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
San gerardo Hospital, Monza, Italy.
Arch Gynecol Obstet. 2021 Dec;304(6):1493-1499. doi: 10.1007/s00404-021-06076-w. Epub 2021 May 22.
Delayed cord clamping for at least 60 s is recommended to improve neonatal outcomes. The aim of this study is to evaluate whether there are differences in cord BGA between samples collected after double clamping the cord or without clamping the cord, when blood collection occurs within 60 s from birth in both groups.
A cross-sectional study was carried out, collecting data from 6884 high-risk women who were divided into two groups based on the method of cord sampling (clamped vs unclamped).
There were significant decrease in pH and BE values into unclamped group compared with the clamped group. This difference remained significant when considering pathological blood gas analysis parameters, with a higher percentage of pathological pH or BE values in the unclamped group.
Samples from the unclamped cord alter the acid-base parameters compared to collection from the clamped cord; however, this difference does not appear to be of clinical relevance. Findings could be due to the large sample size, which allowed to achieve a high power and to investigate very small numerical changes between groups, leading to a statistically significant difference in pH and BE between samples even when we could not appreciate any clinical relevant difference of pH or BE between groups. When blood gas analysis is indicated, the priority should be given to the timing of blood collection to allow reliable results, to assess newborns status at birth and intervene when needed.
建议至少延迟夹闭脐带 60 秒以改善新生儿结局。本研究旨在评估在两组均于出生后 60 秒内采血的情况下，与不夹闭脐带相比，双夹脐带后采集样本与不夹闭脐带时采集的样本之间的脐血 BGA 是否存在差异。
进行了一项横断面研究，共收集了 6884 名高危产妇的数据，这些产妇根据脐带取样方法（夹闭 vs 不夹闭）分为两组。
与夹闭组相比，不夹闭组的 pH 值和 BE 值显著降低。当考虑病理性血气分析参数时，这种差异仍然显著，不夹闭组病理性 pH 值或 BE 值的比例更高。
与夹闭脐带采集的样本相比，不夹闭脐带的样本会改变酸碱参数；然而，这种差异似乎没有临床意义。这一结果可能是由于样本量较大，能够达到较高的效能，并对两组之间非常小的数值变化进行研究，从而导致 pH 值和 BE 值在样本之间存在统计学上显著差异，即使我们无法观察到 pH 值或 BE 值在组之间存在任何临床相关差异。当需要进行血气分析时，应优先考虑采血时间，以确保获得可靠的结果，评估新生儿出生时的状况，并在需要时进行干预。
