Effects of Delayed Cord Clamping on 4-Month Ferritin Levels, Brain Myelin Content, and Neurodevelopment: A Randomized Controlled Trial.
Effects of Delayed Cord Clamping on 4-Month Ferritin Levels, Brain Myelin Content, and Neurodevelopment: A Randomized Controlled Trial.
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DOI：
10.1016/j.jpeds.2018.06.006
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Padbury JF
中科院分区：
文献类型：
--
作者：
Mercer JS;Erickson-Owens DA;Deoni SCL;Dean DC 3rd;Collins J;Parker AB;Wang M;Joelson S;Mercer EN;Padbury JF
评估胎盘输血是否影响4月龄时脑髓鞘形成。在美国一家三级妇产医院进行了一项部分盲法随机对照试验。73名健康足月孕妇及其单胎胎儿被随机分为延迟脐带夹闭组（DCC，>5分钟）和立即夹闭组（ICC，<20秒）。在4个月大时，抽血测定铁蛋白水平。进行神经发育测试（马伦早期学习量表），并用磁共振成像测量脑髓鞘含量。完成了髓鞘含量和铁蛋白水平之间的相关性以及分组DCC与ICC脑髓鞘含量。DCC组和ICC组的钳夹时间分别为172 ± 188秒和28 ± 76秒（P <0.002）; 48小时红细胞压积分别为57.6%和53.1%（P <0.01）。在4个月时，患有DCC的婴儿具有显著更高的铁蛋白水平（96.4 vs 65.3 ng/dL，P = 0.03）。铁蛋白与髓鞘含量呈正相关。随机分配到DCC组的婴儿在内囊和其他与运动、视觉和感觉处理/功能相关的早熟脑区中有更高的髓鞘含量。在马伦检验中未观察到组间差异。在4个月时，足月出生的婴儿接受DCC有更高的铁蛋白水平和增加脑髓鞘的领域，重要的早期生活功能的发展。通过DCC获得的富铁红细胞的捐赠可能为早期白色物质发育提供纵向优势。ClinicalTrials.gov：NCT01620008。
To evaluate whether placental transfusion influences brain myelination at 4 months of age. A partially blinded, randomized controlled trial was conducted at a level III maternity hospital in the US. Seventy-three healthy term pregnant women and their singleton fetuses were randomized to either delayed umbilical cord clamping (DCC, >5 minutes) or immediate clamping (ICC, <20 seconds). At 4 months of age, blood was drawn for ferritin levels. Neurodevelopmental testing (Mullen Scales of Early Learning) was administered, and brain myelin content was measured with magnetic resonance imaging. Correlations between myelin content and ferritin levels and group-wise DCC vs ICC brain myelin content were completed. In the DCC and ICC groups, clamping time was 172 ± 188 seconds vs 28 ± 76 seconds (P < .002), respectively; the 48-hour hematocrit was 57.6% vs 53.1% (P < .01). At 4 months, infants with DCC had significantly greater ferritin levels (96.4 vs 65.3 ng/dL, P = .03). There was a positive relationship between ferritin and myelin content. Infants randomized to the DCC group had greater myelin content in the internal capsule and other early maturing brain regions associated with motor, visual, and sensory processing/function. No differences were seen between groups in the Mullen testing. At 4 months, infants born at term receiving DCC had greater ferritin levels and increased brain myelin in areas important for early life functional development. Endowment of iron-rich red blood cells obtained through DCC may offer a longitudinal advantage for early white matter development. ClinicalTrials.gov: NCT01620008.
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影响因子：
5.7
作者：
Dean DC 3rd;O'Muircheartaigh J;Dirks H;Waskiewicz N;Lehman K;Walker L;Han M;Deoni SC
通讯作者：
Deoni SC
影响因子：
2.3
作者：
Dean, Douglas C., III;Dirks, Holly;O'Muircheartaigh, Jonathan;Walker, Lindsay;Jerskey, Beth A.;Lehman, Katie;Han, Michelle;Waskiewicz, Nicole;Deoni, Sean C. L.
通讯作者：
Deoni, Sean C. L.
影响因子：
26.1
作者：
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通讯作者：
Hellstrom-Westas, Lena
影响因子：
26.1
作者：
Andersson, Ola;Domellof, Magnus;Hellstrom-Westas, Lena
通讯作者：
Hellstrom-Westas, Lena
影响因子：
3.3
作者：
Deoni, Sean C. L.;Rutt, Brian K.;Jones, Derek K.
通讯作者：
Jones, Derek K.