Delayed versus Immediate Cord Clamping in Preterm Infants
| العنوان: | Delayed versus Immediate Cord Clamping in Preterm Infants |
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| المؤلفون: | Kjersti Aagaard, Leslie Young, Daniele De Luca, Andrew W. Gill, Martin Kluckow, Roger Soll, Lisa M. Askie, Euan M. Wallace, John Simes, Harshad Patel, William Tarnow-Mordi, Nick Evans, Susan P. Walker, Peta M. Forder, Mohamed E Abdel-Latif, Arvind Sehgal, Lelia Duley, Margo Pritchard, Yan Chen, Adrienne Kirby, Guan Koh, Shabina Ariff, Lumaan Sheikh, David Isaacs, Val Gebski, Katie M. Groom, Michael Fogarty, Helen G. Liley, Kristy P. Robledo, Kei Lui, Walid El-Naggar, Michelle Jeffery, Graham Reynolds, Philip Weston, Rebecca Brown, Anthony C Keech, Koert de Waal, Ian M. R Wright, Himanshu Popat, Paul B. Colditz, Joanna E. Gullam, Scott Morris, Mohan Pammi, David A Osborn, Andrew Watkins, Alpana Ghadge, Lucille Sebastian, Michael A. Belfort, Jonathan M. Morris, Karen Simmer, David G. Sweet, Sarah Finlayson, John P. Newnham, Neil Marlow, Wendy Hague |
| المصدر: | New England Journal of Medicine. 377:2445-2455 |
| بيانات النشر: | Massachusetts Medical Society, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Time Factors, Infant, Premature, Diseases, Umbilical cord, Umbilical Cord, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, 030225 pediatrics, medicine, Humans, Placental Circulation, 030212 general & internal medicine, Perinatal Mortality, Fetus, business.industry, Incidence, Infant, Newborn, Postmenstrual Age, Retinopathy of prematurity, General Medicine, Delivery, Obstetric, medicine.disease, Constriction, Surgery, medicine.anatomical_structure, Hematocrit, Anesthesia, Necrotizing enterocolitis, Apgar Score, Gestation, Female, Apgar score, business, Infant, Premature |
| الوصف: | Background: The preferred timing of umbilical-cord clamping in preterm infants is unclear. Methods: We randomly assigned fetuses from women who were expected to deliver before 30 weeks of gestation to either immediate clamping of the umbilical cord (≤10 seconds after delivery) or delayed clamping (≥60 seconds after delivery). The primary composite outcome was death or major morbidity (defined as severe brain injury on postnatal ultrasonography, severe retinopathy of prematurity, necrotizing enterocolitis, or late-onset sepsis) by 36 weeks of postmenstrual age. Analyses were performed on an intention-to-treat basis, accounting for multiple births. Results: Of 1634 fetuses that underwent randomization, 1566 were born alive before 30 weeks of gestation; of these, 782 were assigned to immediate cord clamping and 784 to delayed cord clamping. The median time between delivery and cord clamping was 5 seconds and 60 seconds in the respective groups. Complete data on the primary outcome were available for 1497 infants (95.6%). There was no significant difference in the incidence of the primary outcome between infants assigned to delayed clamping (37.0%) and those assigned to immediate clamping (37.2%) (relative risk, 1.00; 95% confidence interval, 0.88 to 1.13; P=0.96). The mortality was 6.4% in the delayed-clamping group and 9.0% in the immediate-clamping group (P=0.03 in unadjusted analyses; P=0.39 after post hoc adjustment for multiple secondary outcomes). There were no significant differences between the two groups in the incidences of chronic lung disease or other major morbidities. Conclusions: Among preterm infants, delayed cord clamping did not result in a lower incidence of the combined outcome of death or major morbidity at 36 weeks of gestation than immediate cord clamping. (Funded by the Australian National Health and Medical Research Council [NHMRC] and the NHMRC Clinical Trials Centre; APTS Australian and New Zealand Clinical Trials Registry number, ACTRN12610000633088. opens in new tab.) |
| تدمد: | 1533-4406 0028-4793 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::876bf3988e2d7f09ad728a22a97329fdTest https://doi.org/10.1056/nejmoa1711281Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....876bf3988e2d7f09ad728a22a97329fd |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15334406 00284793 |
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