断脐时机对母婴结局影响的研究

目的研究断脐时机对母婴结局的影响。方法选取阴道试产的健康足月初产妇随机分为三组,早断脐组(n=108)断脐时机为胎儿娩出即刻至60s,晚断脐1组(n=92)断脐时机为胎儿娩出60~120s,晚断脐2组(n=68)断脐时机为胎儿娩出120s或至脐带停止搏动。追踪至婴儿6月龄。结果三组产妇胎盘剥离时间、产后2h出血量比较,差异无统计学意义(均P0.05)。三组新生儿出生后第4天血红蛋白含量存在统计学差异,晚断脐2组显著高于早断脐组、晚断脐1组(均P0.05)。三组婴儿6月龄血清铁蛋白含量比较,差异有统计学意义(P0.05),晚断脐2组显著高于早断脐组、晚断脐1组(均P0.05)。结论胎儿娩出2min后或脐带停止搏动时断脐不影响分娩进程及产后出血,可提高新生儿血红蛋白水平和6月龄血清铁蛋白含量。

Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes

Objective To determine the effects of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes.Methods Disease-free pregnant women with a gestational age of 37 weeks or greater,and experiencing a spontaneous,vaginal,and single delivery were included in the study.They were allocated into 3 groups receiving more delayed (＞120 seconds after delivery or when cord pulsation has ceased),less delayed (60-120 seconds),or early (in the first 60 seconds) clamping of the umbilical cord during delivery.Infants were followed up until 6 months of age.Results There were no significant differences in time of placental separation and volume of postpartum hemorrhage within the first 2 hours among the 3 groups (P＞0.05 for both).The differences in hemoglobin value at 4 days after birth and in iron transferrin concentration at 6 months of age were significant among the 3 groups,with infants in the more delayed cord clamping group significantly higher compared with infants whose cord clamping was early or less delayed (P＜0.05 for all).Conclusion Clamping the umbilical cord more than two minutes after birth or when cord pulsation has ceased does not have negative effect on delivery process and postpartum hemorrhage,but it increa ses early hemoglobin concentrations and iron stores in infants.