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孕32周以下早产儿过渡期脐带处理策略与氧合情况

Oxygenation associated with cord management strategies among preterm infants <32 weeks gestation during the transition period.

作者信息

Peterson Catherine, Ferrer Lucia, Sanjay Shashank, Poeltler Debra, Lakshminrusimha Satyan, Katheria Anup C

机构信息

Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA, USA.

Department of Pharmaceutical & Clinical Sciences, Campbell University, Buies Creek, NC, USA.

出版信息

J Perinatol. 2025 Jan;45(1):55-62. doi: 10.1038/s41372-024-02127-7. Epub 2024 Oct 11.

DOI:10.1038/s41372-024-02127-7
PMID:39394453
Abstract

OBJECTIVE

Compare changes in SpO and FiO post-birth among preterm infants after delayed cord clamping (DCC), umbilical cord milking (UCM) or early cord clamping (ECC).

STUDY DESIGN

Retrospective study of infants <32 weeks gestation born between 2014 and 2021. ECC was clamping 0-59 s, DCC was clamping ≥60 s after delivery, UCM defined as milking the intact umbilical cord several times before clamping.

RESULTS

Of 463 infants; 257 received DCC, 168 received UCM, 38 received ECC. UCM infants had higher median SpO values at 4-(79% UCM vs 69% DCC, p = 0.027) and 5-(85% UCM vs 80% DCC, p = 0.023) minutes after-birth compared to DCC. DCC and UCM infants required lower FiO levels in the first 5-minutes compared to ECC infants (DCC 0.38 ± 0.17, UCM 0.40 ± 0.20 vs ECC 0.51 ± 0.27, p's <0.001).

CONCLUSION

The proportion of infants achieving SpO ≥ 80% by 5 min was similar in all groups, FiO needed to achieve this goal was higher in ECC infants.

摘要

目的

比较延迟脐带结扎(DCC)、脐带挤血(UCM)或早期脐带结扎(ECC)后早产儿出生后血氧饱和度(SpO)和吸入氧分数(FiO)的变化。

研究设计

对2014年至2021年间出生的孕周<32周的婴儿进行回顾性研究。ECC是在分娩后0 - 59秒结扎脐带,DCC是在分娩后≥60秒结扎脐带,UCM定义为在结扎前多次挤压完整的脐带。

结果

463名婴儿中,257名接受DCC,168名接受UCM,38名接受ECC。与DCC相比,UCM组婴儿出生后4分钟(UCM组为79%,DCC组为69%,p = 0.027)和5分钟(UCM组为85%,DCC组为80%,p = 0.023)时的SpO中位数更高。与ECC组婴儿相比,DCC组和UCM组婴儿在出生后前5分钟需要的FiO水平更低(DCC组0.38±0.17,UCM组0.40±0.20,ECC组0.51±0.27,p值均<0.001)。

结论

所有组中在5分钟时SpO≥80%的婴儿比例相似,ECC组婴儿达到这一目标所需的FiO更高。

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