PDF(Pubmed)
Abstract：
BACKGROUND: Umbilical cord milking (UCM) and delayed cord clamping (DCC) are strategies that improve the hemodynamic condition of the newborn and also increase the storage of iron. This study aimed to compare the effects of DCC with or without milking in late preterm and term neonates at different time intervals after birth (60, 120, and 180 seconds) on hematological and hemodynamic parameters in neonates at six weeks of age.
METHODS: In this double-arm, parallel-group, triple-blind, and active-controlled trial, all 150 eligible neonates were randomized with allocation concealment into three groups: Group A (DCC with UCM at 60 seconds), Group B (DCC with UCM at 120 seconds), and Group C (only DCC for 180 seconds). Hemodynamic parameters were recorded and compared during the first 48 hours, and hematological parameters were compared at six weeks of age.
RESULTS: At six weeks, a significant difference in hemoglobin levels was noted between Groups A, B, and C (p<0.001). The difference in serum ferritin values at six weeks was also statistically significant in comparisons across all three groups (p=0.003). Regarding secondary outcomes examined, hemodynamic parameters and the incidence of neonatal hyperbilirubinemia were found to be comparable at 48 hours after birth.
CONCLUSIONS: DCC followed by UCM at 120 seconds and DCC till 180 seconds proves superior to DCC with UCM at 60 seconds in preserving elevated hemoglobin levels and iron stores in neonates at six weeks of age. DCC for 180 seconds yielded comparable results, followed by UCM at 120 seconds. All three methods are considered safe and effective without compromising the neonate\'s hemodynamics.
METHODS: In this double-arm, parallel-group, triple-blind, and active-controlled trial, all 150 eligible neonates were randomized with allocation concealment into three groups: Group A (DCC with UCM at 60 seconds), Group B (DCC with UCM at 120 seconds), and Group C (only DCC for 180 seconds). Hemodynamic parameters were recorded and compared during the first 48 hours, and hematological parameters were compared at six weeks of age.
RESULTS: At six weeks, a significant difference in hemoglobin levels was noted between Groups A, B, and C (p<0.001). The difference in serum ferritin values at six weeks was also statistically significant in comparisons across all three groups (p=0.003). Regarding secondary outcomes examined, hemodynamic parameters and the incidence of neonatal hyperbilirubinemia were found to be comparable at 48 hours after birth.
CONCLUSIONS: DCC followed by UCM at 120 seconds and DCC till 180 seconds proves superior to DCC with UCM at 60 seconds in preserving elevated hemoglobin levels and iron stores in neonates at six weeks of age. DCC for 180 seconds yielded comparable results, followed by UCM at 120 seconds. All three methods are considered safe and effective without compromising the neonate\'s hemodynamics.
摘要：
背景：脐带挤奶（UCM）和延迟脐带夹紧（DCC）是改善新生儿血液动力学状况并增加铁储存的策略。这项研究旨在比较在出生后不同时间间隔（60、120和180秒）的晚期早产和足月新生儿有或没有挤奶的DCC对6周龄新生儿血液和血流动力学参数的影响。
方法：在这种双臂中，平行组，三盲，和主动对照试验，所有150例符合条件的新生儿被随机分配隐藏分为三组：A组（DCC在60秒时使用UCM），B组（120秒时带有UCM的DCC），和C组（仅DCC180秒）。在最初的48小时内记录并比较血液动力学参数，在6周龄时比较血液学参数。
结果：在六周时，A组之间的血红蛋白水平存在显着差异，B,和C(p<0.001)。6周时血清铁蛋白值的差异在所有三组的比较中也具有统计学显著性(p=0.003)。关于次要结果的检查，发现出生后48小时的血流动力学参数和新生儿高胆红素血症的发生率具有可比性。
结论：DCC后120秒UCM和DCC后180秒证明在保持6周龄新生儿血红蛋白水平和铁储备升高方面优于DCC后60秒UCM。180秒的DCC产生了可比的结果，接下来是UCM在120秒。所有这三种方法都被认为是安全有效的，不会损害新生儿的血液动力学。
方法：在这种双臂中，平行组，三盲，和主动对照试验，所有150例符合条件的新生儿被随机分配隐藏分为三组：A组（DCC在60秒时使用UCM），B组（120秒时带有UCM的DCC），和C组（仅DCC180秒）。在最初的48小时内记录并比较血液动力学参数，在6周龄时比较血液学参数。
结果：在六周时，A组之间的血红蛋白水平存在显着差异，B,和C(p<0.001)。6周时血清铁蛋白值的差异在所有三组的比较中也具有统计学显著性(p=0.003)。关于次要结果的检查，发现出生后48小时的血流动力学参数和新生儿高胆红素血症的发生率具有可比性。
结论：DCC后120秒UCM和DCC后180秒证明在保持6周龄新生儿血红蛋白水平和铁储备升高方面优于DCC后60秒UCM。180秒的DCC产生了可比的结果，接下来是UCM在120秒。所有这三种方法都被认为是安全有效的，不会损害新生儿的血液动力学。
