Effect of delayed cord clamping on short term clinical and laboratory findings in term and late preterm infants
Öz
Purpose: Delaying the cord clamping for at least 30 seconds in infants who did not require cardiopulmonary resuscitation after birth has been recommended in the revised guidelines of American Academy of Pediatrics in 2015. We aimed to evaluate the effect of delayed cord clamping on hematological and biochemical parameters, need for hospitalization, oxygen, mechanical ventilation, phototherapy, and on sepsis, hyperbilirubinemia rate in late preterm and term infants.
Material and Methods: This prospective study included 86 infants with a gestational age of 34 to 41 weeks. Infants were randomly included in one of two groups. While cords of 43 infants were clamped immediately after birth, cords of the other 43 infants were clamped after one minute. Hematological and biochemical values were evaluated both in cord blood and venous blood samples on 7th day of life.
Results: Hemoglobin and hematocrit values were similar in two groups both in cord blood and on 7th day of life. Delayed cord clamping resulted in statistically significant decrease in the leukocyte and platelet coun and creatinine levels in the cord blood. Mechanical ventilation requirement was significantly lower in the delayed cord clamping group. Hospitalization rate, sepsis rate and hyperbilirubinemia rate were similar in both groups.
Conclusion: Delayed cord clamping caused lower leucocyte, platelet counts and lower creatinine levels in cord blood. There seems a beneficial effect on respiratory status in late preterm and term infants.
Anahtar Kelimeler
Infants cord clamping time creatinine level leucocyte level mechanical ventilation
Destekleyen Kurum
This project was supported by Çukurova University, Unit of Scientific Research Projects.
Proje Numarası
Project No: TTU-2017-7713
Kaynakça
- 1. Raju TN. Timing of umbilical cord clamping after birth for optimizing placental transfusion. Curr Opin Pediatr 2013; 25:180-187.
- 2. Gallagher PG. The Neonatal Erythrocyte and It’s Disorders. In:Orkin SH, Fisher DE, Ginsberg D, Look AT, Lux SE, Nathan DG, Eds. Nathan and Oski’s hematology and Oncology of Infancy and Chilhood. 8th Edition, Philadelphia: Elsevier; 2015:52-70.
- 3. Lainez Villabona B, Bergel Ayllon E, Cafferata Thompson ML. Belizán Chiesa JM. Early or late umbilical cord clamping? A systematic review of the literature. An Pediatr. 2005; 63:14-21.(Abstract)
- 4. Oxford Midwives Research Group. A study of the relationship between the delivery to cord clamping interval and the time of cord separation. Midwifery 1991; 7:167-176.
- 5. Linderkamp O, Nelle M, Kraus M, Zilow EP. The effects of early and late cord-clamping on blood viscosity and other hemorheological parameters in full-term neonates. Acta Paediatrica 1992; 81:745-750.
- 6. Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part13: Neonatal Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132:543-560.
- 7. Çoban A, Türkmen M, Gürsoy T. Türk Neonatoloji Derneği Yenidoğan Sarılıklarında Yaklaşım, İzlem ve Tedavi Rehberi, 2014:20-25. Erişim: http://www.neonatology.org.tr/wp-content/ uploads/2016/12/sarilik.pdf.
- 8. Satar M, Arısoy A. Türk Neonatoloji Derneği Yenidoğan Enfeksiyonları Tedavi ve İzlem Rehberi-2014:6-11, Erişim: http://www.neonatology.org.tr/wp-content/uploads/2016/12/enfeksiyon.pdf
- 9. Kc A, Målqvist M, Rana N, Ranneberg LJ, Andersson O. Effect of timing of umbilical cord clamping on anaemia at 8 and 12 months and later neurodevelopment in late pre-term and term infants. BMC Pediatr 2016; 16:35-36.
- 10. Chaparro CM, Lutter C. Beyond survival: integrated delivery care practices for longterm maternal and infant nutrition, health and development. Washington: Pan American Health Organization; 2007:5-15.
- 11. Rabe H, Reynolds G, Diaz-Rossello J. A systematic review and meta-analysis of a brief delay in clamping the umbilical cord of preterm infants. Neonatology 2008; 93:138-144.
- 12. McDonald SJ, Middleton P, Dowswell T, Morris S. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev 2014; 9:303-397.
- 13. Emamed MO, Van Rheenen P, Brabin BJ. The early effects of delayed cord clamping in term infants born to Libyan mothers. Trop Doct 2004; 34:218-222.
- 14. Shirvani F, Radfar M, Hashemieh M, Soltanzadeh MH, Khaledi H, Mogadam MA. Effect of timing of umbilical cord clamp on newborns' iron status and its relation to delivery type. Arch Iran Med 2010; 13:420-425.
- 15. Ceriani Cernadas JM, Carroli G, Pellegrini L, Otaño L, Ferreira M, Ricci C, et al. The effect of timing of cord clamping on neonatal venous hematocrit values and clinical outcome at term: a randomized, controlled trial. Pediatrics 2006; 117:779-786.
- 16. Dicky O, Ehlinger V, Guyard-Boileau B, Assouline C, Arnaud C, Casper C. Delayed umbilical cord clamping in preterm infants born before 37 weeks of gestation: A prospective observational study. Arch Pediatr 2017; 24:118-125.
- 17. Oliveira F de C, Assis KF, Martins MC, Prado MR, Ribeiro AQ, Sant'Ana LF, et al. Timing of clamping and factors associated with iron stores in full-term newborns. Rev Saude Publica 2014; 48:10-18.
- 18. Kilicdag H, Gulcan H, Hanta D, Torer B, Gokmen Z, Ozdemir SI et al. Is umbilical cord milking always an advantage? J Matern Fetal Neonatal Med 2016; 29:615-618.
- 19. Ertekin AA, Nihan Ozdemir N, Sahinoglu Z, Gursoy T, Erbil N, Kaya E. Term babies with delayed cord clamping: an approach in preventing anemia. J Matern Fetal Neonatal Med 2016; 29:2813–2816.
- 20. Qian Y, Ying X, Wang P, Lu Z, Hua Y. Early versus delayed umbilical cord clamping on maternal and neonatal outcomes. Arch Gynecol Obstet 2019; 300:531-543.
- 21. Ceriani Cernadas JM, Carroli G, Pellegrini L, Ferreira M, Ricci C, Casas O, et al. The effect of early and delayed umbilical cordclamping on ferritin levels in term infants at six months of life: a randomized, controlled trial. Arch Argent Pediatr 2010; 108:201-208.
- 22. Mercer JS, Vohr BR, McGrath MM, Padbury JF, Wallach M, Oh W. Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics 2006; 117:1235-1242.
- 23. Menget A, Mougey C, Thiriez G, Riethmuller D. Advantage of delayed umbilical cord clamping in newborn infant. Arch Pediatr. 2013; 20:1022-1027.
- 24. Dong XY, Güneş XF, Li MM, Yu ZB, Han SP. Influence of delayed cordclamping on preterm infants with a gestational age of <32 weeks. Zhongguo Dang Dai Er Ke Za Zhi, 2016; 18:635-638.(Abstract)
- 25. Hutton EK, Hasan ES. Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. JAMA 2007; 297:1241-1252.
- 26. Duley L, Batey N. Optimal timing of umbilical cord clamping for term and preterm babies, Early Hum Dev 2013; 89:905-908.
Geciktirilmiş kord klemplemenin term ve geç preterm bebeklerin kısa dönem klinik ve laboratuvar bulgularına etkisi
Öz
Amaç: Amerikan Pediatri Akademisi tarafından 2015 protokollerinde doğumdan sonra canlandırma ihtiyacı olmayan bebeklerde kord klemplenmesinin en az 30 dk geciktirilmesi önerilmiştir. Bu çalışmada term ve geç preterm bebeklerde geciktirilmiş kord klemplemenin, hematolojik ve biyokimyasal parametreler, hastaneye yatış, oksijen, mekanik ventilasyon, fototerapi ihtiyacına ve sepsis, hiperbilirubinemi hızına etkisini değerlendirmeyi amaçladık.
Yöntem: Prospektif çalışmamıza 34-41 gebelik haftasındaki 86 bebek dahil edildi. Bebekler randomize olarak iki gruba ayrıldı. 43 bebeğin göbek kordonu doğumdan hemen sonra klemplenirken diğer 43 bebeğin kordonu doğumdan 1 dakika sonra klemplendi. Hematolojik ve biyokimyasal parametreler hem kord kanında hem de postnatal 7. günde alınan venöz örneklerde değerlendirildi.
Bulgular: Hemoglobin ve hematokrit değerleri hem kord kanında hem de postanal 7. günde her iki grupta da benzerdi. Geciktirilmiş kord klemplenen grupta kord kanında lökosit ve tombosit değerleri istatistiksel olarak anlamlı düşüktü. Geciktirilmiş kord klemplenen grupta kord kanında kreatinin düzeyi anlamlı olarak düşük saptandı. Mekanik ventilasyon ihtiyacı kordu geç klemplenen grupta daha azdı. Hastaneye yatış, sepsis ve hiperbilirubinemi hızı her iki grupta da benzerdi.
Sonuç: Geciktirilmiş kord klemplemesinin term ve geç preterm bebeklerde lökosit, trombosit ve kreatinin düzeylerinde düşüklüğe neden olduğu, solunum üzerine olumlu etkileri olduğu düşünüldü.
Anahtar Kelimeler
bebekler kord klempleme zamanı kreatinine lökosit sayısıs mekanik ventilasyon
Proje Numarası
Project No: TTU-2017-7713
Kaynakça
- 1. Raju TN. Timing of umbilical cord clamping after birth for optimizing placental transfusion. Curr Opin Pediatr 2013; 25:180-187.
- 2. Gallagher PG. The Neonatal Erythrocyte and It’s Disorders. In:Orkin SH, Fisher DE, Ginsberg D, Look AT, Lux SE, Nathan DG, Eds. Nathan and Oski’s hematology and Oncology of Infancy and Chilhood. 8th Edition, Philadelphia: Elsevier; 2015:52-70.
- 3. Lainez Villabona B, Bergel Ayllon E, Cafferata Thompson ML. Belizán Chiesa JM. Early or late umbilical cord clamping? A systematic review of the literature. An Pediatr. 2005; 63:14-21.(Abstract)
- 4. Oxford Midwives Research Group. A study of the relationship between the delivery to cord clamping interval and the time of cord separation. Midwifery 1991; 7:167-176.
- 5. Linderkamp O, Nelle M, Kraus M, Zilow EP. The effects of early and late cord-clamping on blood viscosity and other hemorheological parameters in full-term neonates. Acta Paediatrica 1992; 81:745-750.
- 6. Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part13: Neonatal Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132:543-560.
- 7. Çoban A, Türkmen M, Gürsoy T. Türk Neonatoloji Derneği Yenidoğan Sarılıklarında Yaklaşım, İzlem ve Tedavi Rehberi, 2014:20-25. Erişim: http://www.neonatology.org.tr/wp-content/ uploads/2016/12/sarilik.pdf.
- 8. Satar M, Arısoy A. Türk Neonatoloji Derneği Yenidoğan Enfeksiyonları Tedavi ve İzlem Rehberi-2014:6-11, Erişim: http://www.neonatology.org.tr/wp-content/uploads/2016/12/enfeksiyon.pdf
- 9. Kc A, Målqvist M, Rana N, Ranneberg LJ, Andersson O. Effect of timing of umbilical cord clamping on anaemia at 8 and 12 months and later neurodevelopment in late pre-term and term infants. BMC Pediatr 2016; 16:35-36.
- 10. Chaparro CM, Lutter C. Beyond survival: integrated delivery care practices for longterm maternal and infant nutrition, health and development. Washington: Pan American Health Organization; 2007:5-15.
- 11. Rabe H, Reynolds G, Diaz-Rossello J. A systematic review and meta-analysis of a brief delay in clamping the umbilical cord of preterm infants. Neonatology 2008; 93:138-144.
- 12. McDonald SJ, Middleton P, Dowswell T, Morris S. Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database Syst Rev 2014; 9:303-397.
- 13. Emamed MO, Van Rheenen P, Brabin BJ. The early effects of delayed cord clamping in term infants born to Libyan mothers. Trop Doct 2004; 34:218-222.
- 14. Shirvani F, Radfar M, Hashemieh M, Soltanzadeh MH, Khaledi H, Mogadam MA. Effect of timing of umbilical cord clamp on newborns' iron status and its relation to delivery type. Arch Iran Med 2010; 13:420-425.
- 15. Ceriani Cernadas JM, Carroli G, Pellegrini L, Otaño L, Ferreira M, Ricci C, et al. The effect of timing of cord clamping on neonatal venous hematocrit values and clinical outcome at term: a randomized, controlled trial. Pediatrics 2006; 117:779-786.
- 16. Dicky O, Ehlinger V, Guyard-Boileau B, Assouline C, Arnaud C, Casper C. Delayed umbilical cord clamping in preterm infants born before 37 weeks of gestation: A prospective observational study. Arch Pediatr 2017; 24:118-125.
- 17. Oliveira F de C, Assis KF, Martins MC, Prado MR, Ribeiro AQ, Sant'Ana LF, et al. Timing of clamping and factors associated with iron stores in full-term newborns. Rev Saude Publica 2014; 48:10-18.
- 18. Kilicdag H, Gulcan H, Hanta D, Torer B, Gokmen Z, Ozdemir SI et al. Is umbilical cord milking always an advantage? J Matern Fetal Neonatal Med 2016; 29:615-618.
- 19. Ertekin AA, Nihan Ozdemir N, Sahinoglu Z, Gursoy T, Erbil N, Kaya E. Term babies with delayed cord clamping: an approach in preventing anemia. J Matern Fetal Neonatal Med 2016; 29:2813–2816.
- 20. Qian Y, Ying X, Wang P, Lu Z, Hua Y. Early versus delayed umbilical cord clamping on maternal and neonatal outcomes. Arch Gynecol Obstet 2019; 300:531-543.
- 21. Ceriani Cernadas JM, Carroli G, Pellegrini L, Ferreira M, Ricci C, Casas O, et al. The effect of early and delayed umbilical cordclamping on ferritin levels in term infants at six months of life: a randomized, controlled trial. Arch Argent Pediatr 2010; 108:201-208.
- 22. Mercer JS, Vohr BR, McGrath MM, Padbury JF, Wallach M, Oh W. Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics 2006; 117:1235-1242.
- 23. Menget A, Mougey C, Thiriez G, Riethmuller D. Advantage of delayed umbilical cord clamping in newborn infant. Arch Pediatr. 2013; 20:1022-1027.
- 24. Dong XY, Güneş XF, Li MM, Yu ZB, Han SP. Influence of delayed cordclamping on preterm infants with a gestational age of <32 weeks. Zhongguo Dang Dai Er Ke Za Zhi, 2016; 18:635-638.(Abstract)
- 25. Hutton EK, Hasan ES. Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. JAMA 2007; 297:1241-1252.
- 26. Duley L, Batey N. Optimal timing of umbilical cord clamping for term and preterm babies, Early Hum Dev 2013; 89:905-908.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Yoğun Bakım |
| Bölüm | Araştırma |
| Yazarlar | |
| Proje Numarası | Project No: TTU-2017-7713 |
| Yayımlanma Tarihi | 27 Aralık 2020 |
| Kabul Tarihi | 20 Ekim 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 45 Sayı: 4 |
