Akyol Ozkara Kamile, Alan Serdar, Ozalp Akin Ezgi, Okulu Emel, Bingoler Pekcici Emine Bahar, Erdeve Omer, Atasay Begüm, Arsan Saadet
Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
Division of Neonatology, Department of Pediatrics, Kirikkale University School of Medicine, Yahsihan/Kırıkkale, Turkey.
Eur J Pediatr. 2025 Jul 1;184(7):462. doi: 10.1007/s00431-025-06299-y.
UNLABELLED: To evaluate the effect of intact cord milking (I-UCM) compared to immediate cord clamping (ICC) on neurodevelopmental outcomes at seven years of age in very preterm infants. This prospective single-blind cohort study included children who were previously participated in a randomized controlled trial comparing I-UCM and ICC. At about 7 years of age, participants were administered the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). A total of 31 children were included in the follow-up study. The mean age of participants was 6.4 ± 0.5 years. The mean gestational age at birth was 28.5 ± 1.7 weeks. There were no cases with grade ≥ 3 intraventriculary hemorrhage (IVH) in the present study cohort. Although the I-UCM group showed a trend toward higher median full-scale IQ, the difference was not statistically significant (p: 0.057). A significantly higher percentage of cases in the I-UCM group achived a full-scale IQ above 85 in the WISC-IV (p = 0.048). The mean of the "written language scaled score" subdomain among Vineland-II scores was found to be significantly higher in the I-UCM group. A significantly higher percentage of cases in the I-UCM group had a written language scaled score above 12 (p: 0.029). CONCLUSION: A comparison of I-UCM with ICC in preterm infants born at a mean age of 28 weeks and without severe IVH revealed that I-UCM did not result in long-term neurodevelopmental adverse outcomes. I-UCM even had positive effects in some subdomains of detailed neurodevelopmental tests. WHAT IS KNOWN: • Compared to immediate cord clamping, umbilical cord milking improves the short-term postnatal outcomes of very preterm infants. There is a lack of robust data regarding the long-term neurodevelopmental effects of umbilical cord milking in preterm infants. WHAT IS NEW: • Among very preterm infants without severe intraventricular hemorrhage, intact umbilical cord milking was not associated with long-term adverse neurodevelopmental outcomes. Intact-umbilical cord milking even had positive effects in some subdomains of detailed neurodevelopmental tests.
未标注：为评估与即刻脐带结扎（ICC）相比，完整脐带挤血（I-UCM）对极早产儿7岁时神经发育结局的影响。这项前瞻性单盲队列研究纳入了先前参与比较I-UCM和ICC的随机对照试验的儿童。在大约7岁时，对参与者进行了《文兰适应行为量表》第二版（Vineland-II）和《韦氏儿童智力量表》第四版（WISC-IV）测试。共有31名儿童纳入随访研究。参与者的平均年龄为6.4±0.5岁。出生时的平均胎龄为28.5±1.7周。本研究队列中无≥3级脑室内出血（IVH）病例。虽然I-UCM组的全量表智商中位数有升高趋势，但差异无统计学意义（p：0.057）。I-UCM组在WISC-IV中全量表智商高于85的病例百分比显著更高（p = 0.048）。发现I-UCM组在Vineland-II评分中“书面语言量表得分”子领域的平均分显著更高。I-UCM组书面语言量表得分高于12的病例百分比显著更高（p：0.029）。 结论：对平均胎龄28周出生且无严重IVH的早产儿进行I-UCM与ICC的比较发现，I-UCM不会导致长期神经发育不良结局。I-UCM甚至在详细神经发育测试的某些子领域有积极作用。 已知信息：•与即刻脐带结扎相比，脐带挤血可改善极早产儿的短期产后结局。关于脐带挤血对早产儿长期神经发育影响的数据不足。 新发现：•在无严重脑室内出血的极早产儿中，完整脐带挤血与长期不良神经发育结局无关。完整脐带挤血甚至在详细神经发育测试的某些子领域有积极作用。
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