Factors associated with rates and durations of cord clamping practice compliance in preterm neonates of <33 weeks' gestation.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-06-01 Epub Date: 2025-06-06 DOI:10.1038/s41372-025-02328-8

Belinda Chan, Joseph Y Ting, Eugene Yoon, Sarah D McDonald, Melissa Orton, Ivah Floyd, Marc M Beltempo, Amit Mukerji, Sajit Augustine, Kevin Coughlin, Prakesh S Shah

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引用次数: 0

Abstract

Objectives: To determine maternal, neonatal, and hospital factors influencing deferred cord clamping (DCC) compliance rates in preterm neonates.

Methods: Neonates born <33 weeks' gestational age (GA) within the Neonatal Intensive Care Units of Canadian Neonatal Network during 2018-2022 were included. Units' DCC quality improvement (QI) efforts were surveyed. The factors were stratified by <15 seconds (s) immediate cord clamping, 15-59 s early cord clamping, or ≥60 s DCC.

Results: Of 16,217 eligible neonates, only 45% received DCC ≥ 60 s. Maternal hypertension and antenatal steroid was asscoiated with higher DCC rates. Cesarean delivery (aOR 0.39, 95% CI 0.33-0.47), <26 weeks GA (aOR 0.25, 95% CI 0.21-0.30), and small-for-gestational-age status had lower DCC odds. Singleton birth, preterm labor, and fetal indications for delivery increased DCC likelihood. Hospital size and QI efforts did not impact DCC compliance.

Conclusion: Extreme preterm neonates or cesarean delivery are actionable QI targets to improve DCC compliance and neonatal outcomes.

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妊娠<33周的早产儿脐带夹紧实践依从率和持续时间的相关因素

目的：确定影响早产儿延迟脐带夹紧（DCC）依从率的产妇、新生儿和医院因素。结果：16217例符合条件的新生儿中，只有45%接受DCC≥60 s。产妇高血压和产前类固醇与较高的DCC率相关。剖宫产（aOR 0.39, 95% CI 0.33-0.47）。结论：极端早产或剖宫产是改善DCC依从性和新生儿结局的可行QI指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.