Neonatal Research Institute at Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA, USA.
Specialty Obstetrics, San Diego, CA, USA.
J Perinatol. 2023 Jan;43(1):39-43. doi: 10.1038/s41372-022-01558-4. Epub 2022 Nov 10.
Determine effect of at least 60 s delayed cord clamping (DCC) on postpartum hemorrhage and maternal estimated blood loss (EBL) in very low birth weight (VLBW) cesarean deliveries when compared to early cord clamping (ECC).
Retrospective study of VLBW infants at birth. Maternal pre- and post-operative hemoglobin, EBL, and neonatal outcomes were collected.
In total, 620 VLBW infants (DCC = 166, ECC = 454) born to 545 mothers (DCC = 155, ECC = 390) were included. Maternal PPH between DCC was 8% versus ECC was 10% p = 0.52. There were no differences in estimated blood loss or rate of maternal blood transfusion between groups. The post-operative hemoglobin was lower in infants receiving ECC compared to DCC (10.4 [9.4-11.5] versus 10.8 [10.1-11.9] g/dl, p = 0.01). In comparing pre-operative to post-operative hemoglobin there was no difference between DCC and ECC (-1.2 [-2.0 to -0.3] versus -1.2 [-2.1 to -0.6] g/dl, p = 0.46).
DCC of at least 60 s did not increase maternal bleeding complications during VLBW cesarean delivery. To our knowledge, this retrospective study is the largest sample size to date of preterm cesarean deliveries to support maternal safety regarding bleeding complications after delayed cord clamping.
与早期脐带夹闭（ECC）相比，确定至少 60 秒延迟脐带夹闭（DCC）对极低出生体重（VLBW）剖宫产产后出血和产妇估计失血量（EBL）的影响。
VLBW 婴儿出生时的回顾性研究。收集产妇术前和术后血红蛋白、EBL 和新生儿结局。
共有 620 名 VLBW 婴儿（DCC=166，ECC=454）出生于 545 名母亲（DCC=155，ECC=390）。DCC 组产妇 PPH 为 8%，ECC 组为 10%，p=0.52。两组间估计失血量或产妇输血率无差异。与 DCC 相比，ECC 组婴儿术后血红蛋白较低（10.4[9.4-11.5]与 10.8[10.1-11.9]g/dl，p=0.01）。比较 DCC 和 ECC 组术前与术后血红蛋白，差异无统计学意义（-1.2[-2.0 至-0.3]与-1.2[-2.1 至-0.6]g/dl，p=0.46）。
在 VLBW 剖宫产中，至少 60 秒的 DCC 不会增加产妇出血并发症。据我们所知，这项回顾性研究是迄今为止关于延迟脐带夹闭后产妇出血并发症的最大早产儿剖宫产样本量研究，支持产妇安全。
