延迟断脐对妊娠期糖尿病新生儿脐动脉血气及黄疸的影响

doi:10.3969/j.issn.2095-9400.2021.07.007

Abstract
Figure/Table
References (17)
Related Citation (0)

Download: PDF (1323 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To investigate the effect of delayed cord clamping on umbilical artery blood gas and jaundice in term infants of diabetic mothers. Methods: Totally 161 full-term pregnant women with gestational diabetes mellitus who delivered in the Second Affiliated Hospital of Wenzhou Medical University from January 2020 to August 2020 were enrolled in this study. They were randomly allocated into the early cord clamping group (<15 seconds, ECC) and the delayed cord clamping group (≥30 seconds, DCC). According to the inclusion and exclusion criteria, 132 cases remained, with 66 cases in the ECC group and 66 cases in the DCC group. The results of umbilical artery blood gas analysis and neonatal transcutaneous bilirubin levels at 1-4 days after birth were compared between the two groups. Results: Arterial cord blood base excess (BE) in the DCC group was significantly lower than that in the ECC group, and lactate was significantly higher [BE: -3.72(-5.58, -2.41) vs.-3.06 (-4.79, -1.62)mmol/L, lactate: 3.0 (2.4, 4.3) vs. 2.1 (1.6, 4.0)mmol/L, P<0.05]. There was no significant difference in pH and bicarbonate (HCO3-) between the two groups [pH: 7.29 (7.24, 7.33) vs. 7.31 (7.25, 7.33),HCO3-: 24.0 (22.5, 25.0) vs. 24.3 (24.3, 25.5)mmol/L, P>0.05]. There were no significant differences in the partial pressure of carbon dioxide (PCO2) and partial pressure of oxygen (PO2) between the two groups (P>0.05). Also, DCC did not improve hemoglobin and hematocrit levels (P>0.05). There was no difference in transcutaneous bilirubin levels at 1-4 days after birth between the two groups (P>0.05), but and the incidence of hyperbilirubinemia in the DCC group was markedly higher than that in the ECC group (17.0% vs. 6.1%) (P<0.05). Conclusion:Delayed cord clamping enhanced anaerobic metabolism, increased metabolic acid in term infants of diabetic mothers, and increased the incidence of neonatal hyperbilirubinemia but did not affect pH value.

Key words： delayed cord clamping gestational diabetes mellitus umbilical artery blood gas analysis neonatal jaundice

Received: 17 December 2020

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	SHAO Hailing
	GAO Shichu
	YING Xinxin
	HUA Ying

URL:

https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2021.07.007 OR https://xb.wmu.edu.cn/EN/Y2021/V51/I7/560

[1] BOERE I, ROEST A A, WALLACE E, et al. Umbilical blood flow patterns directly after birth before delayed cord clamping[J]. Arch Dis Child Fetal Neonatal Ed, 2015,100(2): F121-125.
[2] Committee Opinion No. 684: Delayed umbilical cord clamping after birth[J]. Obstet Gynecol, 2017, 129(1): 1.
[3] WIBERG N, KäLLéN K, OLOFSSON P. Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations[J]. BJOG, 2008,115(6): 697-703.
[4] VALERO J, DESANTES D, PERALES-PUCHALT A,et al. Effect of delayed umbilical cord clamping on blood gas analysis[J]. Eur J Obstet Gynecol Reprod Biol, 2012,162(1): 21-23.
[5] FENTON C, MCNINCH N L, BIEDA A, et al. Clinical outcomes in preterm infants following institution of a delayed umbilical cord clamping practice change[J]. Adv Neonatal Care, 2018, 18(3): 223-231.
[6] GIOVANNINI N, CRIPPA B L, DENARO E, et al. The effect of delayed umbilical cord clamping on cord blood gas analysis in vaginal and caesarean-delivered term newborns without fetal distress: a prospective observational study[J].BJOG, 2020, 127(3): 405-413.
[7] HAPO Study Cooperative Research Group, METZGER B E,LOWE L P, et al. Hyperglycemia and adverse pregnancy outcomes[J]. N Engl J Med, 2008, 358(19): 1991-2002.
[8] MITANCHEZ D, YZYDORCZYK C, SIDDEEK B, et al.The offspring of the diabetic mother——short- and longterm implications[J]. Best Pract Res Clin Obstet Gynaecol, 2015, 29(2): 256-269.
[9] QIAN Y, LU Q, SHAO H, et al. Timing of umbilical cord clamping and neonatal jaundice in singleton term pregnancy[J]. Early Hum Dev, 2020, 142: 104948.
[10] BRADLEY R J, BRUDENELL J M, NICOLAIDES K H.Fetal acidosis and hyperlacticaemia diagnosed by cordocentesis in pregnancies complicated by maternal diabetes mellitus [J]. Diabet Med, 1991, 8(5): 464-468.
[11] WERNER E F, ROMANO M E, ROUSE D J, et al.Association of gestational diabetes mellitus with neonatal respiratory morbidity[J]. Obstet Gynecol, 2019, 133(2): 349-353.
[12] KORKUT S, OğUZ Y, BOZKAYA D, et al. Evaluation of the effects of delayed cord clamping in infants of diabetic mothers[J]. Am J Perinatol, 2021, 38(3): 242-247.
[13] 中华医学会围产医学分会新生儿复苏学组. 新生儿窒息诊断的专家共识[J]. 中华围产医学杂志, 2016, 19(1): 3-6.
[14] DE PACO C, FLORIDO J, GARRIDO M C, et al. Umbilical cord blood acid-base and gas analysis after early versus delayed cord clamping in neonates at term[J]. Arch Gynecol Obstet, 2011, 283(5): 1011-1014.
[15] DE PACO C, HERRERA J, GARCIA C, et al. Effects of delayed cord clamping on the third stage of labour, maternal haematological parameters and acid-base status in fetuses at
term[J]. Eur J Obstet Gynecol Reprod Biol, 2016, 207: 153-156.
[16] CERIANI CERNADAS J M, CARROLI G, PELLEGRINI L,et al. The effect of timing of cord clamping on neonatal venous hematocrit values and clinical outcome at term: a randomized, controlled trial[J]. Pediatrics, 2006, 117(4):e779-786.
[17] CHEN X, LI X, CHANG Y, et al. Effect and safety of timing of cord clamping on neonatal hematocrit values and clinical outcomes in term infants: A randomized controlled trial[J]. J
Perinatol, 2018, 38(3): 251-257.