Neonatal Outcome Following Cord Clamping After Onset of Spontaneous Respiration
Neonatal Outcome Following Cord Clamping After Onset of Spontaneous Respiration
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DOI：
10.1542/peds.2014-0467
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发表时间：
2014-08-01
期刊：
影响因子：
8
通讯作者：
Perlman, Jeffrey
中科院分区：
文献类型：
--
作者：
Ersdal, Hege Langli;Linde, Jorgen;Perlman, Jeffrey
背景和目的：不断发展的数据表明，出生后30到60秒以上的脐带夹闭(CC)对所有婴儿都是有益的。最近的实验数据表明，体外循环前的通风通过增加肺血流量来改善心血管稳定性。方法：在坦桑尼亚一家乡村医院，训练有素的研究助理轮流工作，观察每次分娩(2009年11月至2013年2月)，并记录从出生到自主呼吸(SR)和CC的时间间隔、胎心率、围产期特征和结局(正常、死亡、入院)。结果：在15563名新生儿中，12780名(84.3%)在10.8+/-16.7秒开始自主呼吸，CC发生在出生后63+/-45秒。结果：12730例(99.7%)正常，31例死亡，19例入院；出生体重(BW)和出生体重(Gt；)分别为11967和813
BACKGROUND AND OBJECTIVE: Evolving data indicate that cord clamping (CC) beyond 30 to 60 seconds after birth is of benefit for all infants. Recent experimental data demonstrated that ventilation before CC improved cardiovascular stability by increasing pulmonary blood flow. The objective was to describe the relationship between time to CC, onset of spontaneous respirations (SR), and 24-hour neonatal outcome.METHODS: In a rural Tanzanian hospital, trained research assistants, working in shifts, have observed every delivery (November 2009-February 2013) and recorded data including time interval from birth to SR and CC, fetal heart rate, perinatal characteristics and outcome (normal, death, admission).RESULTS: Of 15 563 infants born, 12 780 (84.3%) initiated SR at 10.8 +/- 16.7 seconds, and CC occurred at 63 +/- 45 seconds after birth. Outcomes included 12 730 (99.7%) normal, 31 deaths, and 19 admitted; 11 967 were of birth weight (BW) >= 2500 g and 813