期刊
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
卷 103, 期 1, 页码 F6-F14出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/archdischild-2016-312567
关键词
-
类别
资金
- National Institute for HealthResearch (NIHR) under its Programme Grants for Applied Research funding scheme [RPPG-0609-10107]
- National Institute for Health Research [RP-PG-0609-10107] Funding Source: researchfish
Objectives For very preterm births, to compare alternative policies for umbilical cord clamping and immediate neonatal care. Design Parallel group randomised (1:1) trial, using sealed opaque numbered envelopes. Setting Eight UK tertiary maternity units. Participants 261 women expected to have a live birth before 32 weeks, and their 276 babies. Interventions Cord clamping after at least 2 min and immediate neonatal care with cord intact, or clamping within 20 s and immediate neonatal care after clamping. Main outcome measures Intraventricular haemorrhage (IVH), death before discharge. Results 132 women (137 babies) were allocated clamping >= 2 min and neonatal care cord intact, and 129 (139) clamping <= 20 sand neonatal care after clamping; six mother-infant dyads were excluded (2, 4) as birth was after 35(+6) weeks, one withdrew (death data only available) (0, 1). Median gestation was 28.9 weeks for those allocated clamping >= 2 min, and 29.2 for those allocated clamping <= 20 s. Median time to clamping was 120 and 11 s, respectively. 7 of 135 infants (5.2%) allocated clamping >= 2 min died and 15 of 135 (11.1%) allocated clamping <= 20s; risk difference (RD) -5.9% (95% CI - 12.4% to 0.6%). Of live births, 43 of 134 (32%) had IVH vs 47 of 132 (36%), respectively; RD -3.5% (-14.9% to 7.8%). There were no clear differences in other outcomes for infants or mothers. Conclusions This is promising evidence that clamping after at least 2 min and immediate neonatal care with cord intact at very preterm birth may improve outcome; a large trial is urgently needed.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据