Jegatheesan Priya, Belogolovsky Esther, Nudelman Matthew, Narasimhan Sudha Rani, Huang Angela, Govindaswami Balaji, Song Dongli
Division of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128, USA.
Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA 94305, USA.
Children (Basel). 2024 Dec 20;11(12):1546. doi: 10.3390/children11121546.
Longer duration of deferred cord clamping (DCC), at least 120 s, is associated with the highest reduction in mortality compared to shorter durations of DCC or immediate cord clamping in preterm infants. We compared the neonatal outcomes of very preterm infants who received at least 60 s to those who received at least 120 s of DCC.
This is a retrospective single-center study including preterm infants born <33 weeks of gestational age (GA) between 2014 and 2019. The intended duration of DCC was 60 s in Period 1 (January 2014 to June 2016, = 139) and 120 to 180 s in Period 2 (July 2016 to December 2019, = 155). We compared the demographics, delivery room measures, and neonatal outcomes between the two periods as intent-to-treat analysis and per protocol analysis.
The intended duration of DCC was completed in 75% of infants in Period 1 ( = 106) and 76% of infants in Period 2 ( = 114). There was an increase in survival without major morbidities in the infants that received at least 120 s of DCC, which remained significant after adjusting for GA and erythropoietin use (Odds ratio 8.6, 95% CI 1.6 to 45.7).
Longer duration of DCC is associated with improved survival without major morbidities in preterm infants <33 weeks GA.
与早产婴儿较短时间的延迟脐带结扎（DCC）或立即脐带结扎相比，较长时间的DCC（至少120秒）与死亡率的最大降低相关。我们比较了接受至少60秒DCC的极早产婴儿与接受至少120秒DCC的极早产婴儿的新生儿结局。
这是一项回顾性单中心研究，纳入了2014年至2019年间孕周小于33周（GA）的早产婴儿。在第1阶段（2014年1月至2016年6月，n = 139），DCC的预期持续时间为60秒，在第2阶段（2016年7月至2019年12月，n = 155）为120至180秒。我们将两个阶段之间的人口统计学、产房指标和新生儿结局作为意向性分析和符合方案分析进行比较。
第1阶段75%（n = 106）的婴儿和第2阶段76%（n = 114）的婴儿完成了DCC的预期持续时间。接受至少120秒DCC的婴儿无重大疾病存活的比例有所增加，在调整GA和促红细胞生成素使用后仍具有显著性（优势比8.6，95%CI 1.6至45.7）。
较长时间的DCC与孕周小于33周的早产婴儿无重大疾病存活的改善相关。
