Zapata Henry A, Todurkar Namrata, Favel Kristen, Griffin Russell L, Starr Michelle C, Charlton Jennifer R, McAdams Ryan M, Askenazi David, Kulkarni Tapas, Menon Shina, Mammen Cherry, Harer Matthew W
University of Florida College of Medicine Jacksonville, Division of Neonatology, Jacksonville, FL, USA.
University of British Columbia, Department of Pediatrics, Vancouver, BC, Canada.
J Perinatol. 2025 Jan;45(1):85-93. doi: 10.1038/s41372-024-02143-7. Epub 2024 Oct 11.
Delayed cord clamping (DCC) occurs in most preterm births.
Evaluate the association of DCC with acute kidney injury (AKI) and two-year kidney outcomes.
Secondary analysis of the Preterm Erythropoietin Neuroprotection Trial of neonates born 24 to 27 weeks gestation. AKI and two year kidney outcomes were compared in neonates with DCC ( ≥ 30 s after delivery) to those with early cord clamping (ECC) (<30 s after delivery).
The incidence and severity of AKI did not differ between the DCC and ECC groups (aOR 1.17 [95%CI 0.76-1.80]). At two years corrected age, DCC was associated with a 4.5-fold increased adjusted odds of estimated glomerular filtration rate (eGFR) <90 mL/min/1.73m. No significant associations were noted between DCC and albuminuria or elevated blood pressure.
DCC was not associated with decreased neonatal AKI, but was associated with higher adjusted odds of eGFR <90 mL/min/1.73m at two years.
大多数早产时会出现延迟脐带结扎（DCC）。
评估延迟脐带结扎与急性肾损伤（AKI）及两年期肾脏预后的关联。
对妊娠24至27周出生的新生儿进行的早产促红细胞生成素神经保护试验的二次分析。比较延迟脐带结扎（出生后≥30秒）的新生儿与早期脐带结扎（出生后<30秒）的新生儿的急性肾损伤和两年期肾脏预后情况。
延迟脐带结扎组和早期脐带结扎组之间急性肾损伤的发生率和严重程度无差异（调整后比值比为1.17 [95%置信区间0.76 - 1.80]）。在矫正年龄两岁时，延迟脐带结扎与估计肾小球滤过率（eGFR）<90 mL/min/1.73m²的调整后比值增加4.5倍相关。延迟脐带结扎与蛋白尿或血压升高之间未发现显著关联。
延迟脐带结扎与新生儿急性肾损伤减少无关，但与两岁时估计肾小球滤过率<90 mL/min/1.73m²的调整后较高比值相关。
