Delayed Cord Clamping in Infants of Diabetic Mothers: Laboratory and Clinical Outcomes

IF 0.3 Q4 PEDIATRICS Journal of Child Science Pub Date : 2021-01-01 DOI:10.1055/s-0041-1726460
S. Abdelmaksoud, Heba Elsayed Abdelraziq, R. Khashaba, A. Diab
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Abstract

Abstract The aim of this study was to compare the effects of delayed cord clamping (DCC) and early cord clamping (ECC) on venous hematocrit (htc) and clinical outcomes in infants of diabetic mothers (IDMs). This prospective randomized study included 157 term IDMs. The umbilical cords of these infants were clamped at least 60 seconds in group I (DCC group, n = 79) and as soon as possible after birth in group II (ECC group, n = 78). The two groups were compared regarding neonatal venous htc levels, hypoglycemia rates, jaundice requiring phototherapy, respiratory distress, and admission to the neonatal intensive care unit (NICU). Hematocrit levels were significantly higher in the DCC group, both at 6 and 24 hours postnatally (p = 0.039 and 0.01), respectively. Polycythemia frequency was higher in DCC than the ECC group, but no patient in either group needed partial exchange transfusion (PET). Rates of jaundice were significantly higher in the DCC group (p = 0.028), but there was no significant difference between the two groups regarding jaundice requiring phototherapy (p = 0.681). There were no differences between the groups regarding hypoglycemia rates, need for glucose infusion, or respiratory distress. The incidence of admission to NICU was lower in the DCC group (p = 0.005). Early clamping was a significant predictor for increased risk of NICU admission. DCC increased polycythemia and jaundice rates but did not increase the need for PET or phototherapy. Also, DCC reduced the severity of respiratory distress and the subsequent need for NICU admission.
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糖尿病母亲婴儿延迟脐带夹闭的实验室和临床结果
摘要本研究的目的是比较延迟脐带夹紧(DCC)和早期脐带夹紧(ECC)对糖尿病母亲(IDMs)婴儿静脉血细胞比容(htc)和临床结果的影响。这项前瞻性随机研究包括157名足月IDM。这些婴儿的脐带被夹住了至少60 第I组(DCC组,n = 79),并在出生后尽快在组II(ECC组,n = 78)。比较两组新生儿静脉htc水平、低血糖率、需要光疗的黄疸、呼吸窘迫和新生儿重症监护室(NICU)的入院情况。DCC组的红细胞压积水平在6岁和24岁时均显著升高 产后小时数(p = 0.039和0.01)。DCC组的红细胞增多症发生率高于ECC组,但两组均无患者需要部分换血(PET)。DCC组的黄疸发生率明显高于对照组(p = 0.028),但两组在需要光疗的黄疸方面没有显著差异(p = 0.681)。两组在低血糖发生率、葡萄糖输注需求或呼吸窘迫方面没有差异。DCC组新生儿重症监护室的入院率较低(p = 0.005)。早期钳夹是NICU入院风险增加的重要预测因素。DCC增加了红细胞增多症和黄疸的发生率,但没有增加PET或光疗的需要。此外,DCC降低了呼吸窘迫的严重程度以及随后需要NICU入院的情况。
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