阴道分娩与急诊剖宫产时早产儿脐带中有核红细胞百分比的比较

Comparison of the Percentage of Umbilical Cord Nucleated Red Blood Cells in Preterm Neonates during Vaginal Delivery and Emergency Cesarean Section.

作者信息

Zakerihamidi Maryam, Heidari Elahe, Boskabadi Hassan

机构信息

Department of Midwifery, School of Medical Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.

Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Iran J Nurs Midwifery Res. 2024 Jan 9;29(1):73-77. doi: 10.4103/ijnmr.ijnmr_122_22. eCollection 2024 Jan-Feb.

DOI:10.4103/ijnmr.ijnmr_122_22

PMID:38333336

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10849285/

Abstract

BACKGROUND

There are insufficient and contradictory reports regarding the effect of delivery method on the rate of umbilical cord Nucleated Red Blood Cell (NRBC). Therefore, the present study aimed to compare the percentages of umbilical cord NRBC in vaginal delivery and emergency cesarean section (C-section) in preterm neonates.

MATERIALS AND METHODS

The present cross-sectional study was performed on mothers with vaginal delivery and C-section, from 2020 to 2021. The samples (n = 221) were preterm neonates selected using the convenience sampling method. The percentages of NRBC in neonates born by natural childbirth and by emergency C-section were measured and compared in this research. A researcher-made checklist, which included maternal and neonatal characteristics and laboratory evaluation, was used as a data collection tool.

RESULTS

The statistical population of thisresearch included 93 (42.10%) and 128 (57.90%) neonates born by vaginal delivery and by C-section, respectively.The mean (SD) score of gestational ages at birth was 30.75 (2.81) weeks. The mean (SD) score of umbilical cord NRBC level were estimated at 8.01 (5.93) and 25.64 (22.61) for the neonates born by natural childbirth and by emergency C-section, respectively (t=-8.43, df = 150, <0.001). Statistically significant differences were observed in the gestational age (t=-3.36, df = 218, = 0.001), fifth-minute Apgar score (t=-2.32, df = 200, p = 0.021), umbilical cord NRBC (t=-8.43, df = 160, p<0.001), and short-term prognosis ( = 0.032) between the two groups. It was also revealed that the number of NRBCs in the dead neonates was about 1.5 times higher than that in the discharged neonates.

CONCLUSIONS

Based on the results of the present study, emergency C-section increased the mean of umbilical cord NRBC by three times, compared to that of normal delivery. Since an increase in the NRBC raises the risk of infant death, it is advisable to take steps to maintain the health of children by identifying high-risk neonates through umbilical cord NRBC measurement immediately after delivery and special care.

摘要

背景

关于分娩方式对脐带中有核红细胞（NRBC）比例的影响，现有报道不足且相互矛盾。因此，本研究旨在比较早产新生儿经阴道分娩和急诊剖宫产时脐带NRBC的百分比。

材料与方法

本横断面研究于2020年至2021年对经阴道分娩和剖宫产的母亲进行。样本（n = 221）为采用便利抽样法选取的早产新生儿。本研究测量并比较了自然分娩和急诊剖宫产出生新生儿的NRBC百分比。一份由研究者制定的检查表用作数据收集工具，该检查表包括母亲和新生儿特征以及实验室评估。

结果

本研究的统计人群分别包括93名（42.10%）经阴道分娩的新生儿和128名（57.90%）剖宫产的新生儿。出生时胎龄的平均（标准差）得分是30.75（2.81）周。自然分娩和急诊剖宫产出生新生儿的脐带NRBC水平平均（标准差）得分分别估计为8.01（5.93）和25.64（22.61）（t = -8.43，自由度 = 150，p <(0.001)）。两组在胎龄（t = -3.36，自由度 = 218，p = (0.001)）、出生后第五分钟阿氏评分（t = -2.32，自由度 = 200，p = (0.021)）、脐带NRBC（t = -8.43，自由度 = 160，p <(0.001)）和短期预后（p = (0.032)）方面存在统计学显著差异。还发现死亡新生儿的NRBC数量比出院新生儿高约1.5倍。