McDonald Sarah D, Narvey Michael, Ehman William, Jain Venu, Cassell Krista
Hamilton, ON.
Winnipeg, MB.
J Obstet Gynaecol Can. 2022 Mar;44(3):313-322.e1. doi: 10.1016/j.jogc.2022.01.007.
To assess the impact of deferred (delayed) cord clamping (DCC) and umbilical cord milking in singleton and twin gestations on maternal and infant mortality and morbidity.
People who are pregnant with preterm or term singletons or twins.
BENEFITS, HARMS, AND COSTS: In preterm singletons, DCC for (ideally) 60 to 120 seconds, but at least for 30 seconds, reduces infant risk of mortality and morbidity. DCC in preterm twins is associated with some benefits. In term singletons, DCC for 60 seconds improves hematological parameters. In very preterm infants, umbilical cord milking increases risk for intraventricular hemorrhage.
Searches of Medline, PubMed, Embase, and the Cochrane Library from inception to March 2020 were undertaken using Medical Subject Heading (MeSH) terms and key words related to deferred cord clamping and umbilical cord milking. This document represents an abstraction of the evidence rather than a methodological review.
The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations).
Maternity and newborn care providers.
评估单胎和双胎妊娠中延迟脐带结扎（DCC）及脐带挤血对母婴死亡率和发病率的影响。
早产或足月单胎或双胎妊娠的孕妇。
益处、危害及成本：在早产单胎中，（理想情况下）延迟脐带结扎60至120秒，但至少30秒，可降低婴儿死亡和发病风险。早产双胎延迟脐带结扎有一些益处。足月单胎延迟脐带结扎60秒可改善血液学参数。在极早早产儿中，脐带挤血会增加脑室内出血风险。
使用医学主题词（MeSH）术语以及与延迟脐带结扎和脐带挤血相关的关键词，检索了自创建至2020年3月的Medline、PubMed、Embase和Cochrane图书馆。本文件代表证据摘要，而非方法学综述。
作者采用推荐分级评估、制定和评价（GRADE）方法对证据质量和推荐强度进行评级。见在线附录A（表A1为定义，表A2为强推荐和有条件[弱]推荐的解释）。
妇产科和新生儿护理人员。
