Tina Perme, Lilijana Kornhauser Cerar, Bernhard Schwaberger, Berndt Urlesberger, Christina Helene Wolfsberger, Nariae Baik, Katharina Goeral, Marlene Hammerl, Eugene M Dempsey, Laila Springer, Gianluca Lista, Tomasz Szczapa, Hans Fuchs, Lukasz Karpinski, Jenny Bua, Alexander Avian, Brenda Hiu Yan Law, Julia Buchmayer, Ursula Kiechl-Kohlendorfer, Christoph E Schwarz, Kerstin Gruendler, Ilaria Stucchi, Katrin Klebermass-Schrehof, Georg M Schmölzer, Gerhard Pichler
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引用次数: 0
Abstract
Aim: To determine how different cord clamping strategies affect cerebral oxygenation in the first 15 min after birth in preterm infants.
Methods: A post-hoc secondary outcome analysis of a multicentre prospective randomised clinical trial (COSGOD III) conducted between October 2017 and October 2021 in 11 tertiary neonatal intensive care units in six countries in Europe and in Canada. In the present ancillary study, all included premature neonates (<32 weeks gestation) were retrospectively assigned to three groups according to the timing of cord clamping (G1<30 s, G2 30-60 s, G3>30 s). The aim of this study was to evaluate differences in cerebral regional oxygen saturation (crSO2) and cerebral fractional tissue oxygen extraction (cFTOE) within the first 15 min after birth in preterm neonates based on the timing of cord clamping.
Results: 572 infants (n=339 (G1), n=164 (G2) and n=69 (G3)) were included in the final ancillary analysis. There were no statistically significant differences in crSO2 and cFTOE between the three groups. There were no statistically significant differences between the three groups in neonatal morbidities, particularly importantly in the degree of cerebral injury, as measured by any degree of intraventricular haemorrhage or cystic periventricular leukomalacia.
Conclusions: No significant differences in crSO2 and cFTOE during the first 15 min after birth were observed; however, some effect may have been modified by protocol-guided titration of supplemental oxygen in the intervention arm. Thus, in our study, we did not find a correlation between deferred cord clamping and improved cerebral oxygenation immediately after birth.
期刊介绍：
Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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