在28至32周的婴儿中,带哺乳与延迟带紧:一个随机试验
Anup Katheria1, Jeff Szychowski2, Waldemar A Carlo2
1Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California.
Pediatrics
|November 9, 2023
概括
带挤奶 (UCM) 和延迟带紧 (DCC) 在早产婴儿中显示出类似的严重腹腔内出血或死亡率. 这两种胎盘输血方法对于早产婴儿在妊娠28周至32周之间出生是安全的.
科学领域:
- 新生儿科学 新生儿科学
- 围产儿医学 围产儿医学
- 儿科重症监护 儿科重症监护
背景情况:
- 严重的腹腔内出血 (IVH) 和死亡是早产婴儿的重大风险.
- 胎盘输血策略,包括带挤奶 (UCM) 和延迟带紧 (DCC),旨在改善新生儿的结局.
- 在早产婴儿中,UCM与DCC的比较安全性和有效性需要进一步研究.
研究的目的:
- 为了确定带挤奶 (UCM) 是否与延迟带紧 (DCC) 相比,在减少早产婴儿严重腹腔内出血 (IVH) 或死亡方面没有劣势.
- 为了比较UCM和DCC组之间的严重IVH (III/IV级) 或死亡率.
主要方法:
- 一个非劣势随机对照试验,涉及早产婴儿出生在妊娠28周和32周之间.
- 带挤奶 (UCM) 与延迟带紧 (DCC) 的比较.
- 评估的主要结局是III/IV级IVH或死亡,1%的非劣势差.
主要成果:
- 这项研究包括1019名早产婴儿 (UCM: n=511; DCC: n=508),平均妊娠年龄为31周.
- 严重IVH或死亡的发生率相同:UCM组的1.4% (7/511) 和DCC组的1.4% (7/508).
- 速率差异为0.01% (95% CI:-1.4%至1.4%),表明非劣势性 (P=.99).
结论:
- 带挤奶 (UCM) 对早产婴儿在妊娠28周至32周之间出生的延迟带紧 (DCC) 没有劣势.
- 两种胎盘输血方法之间没有观察到严重的腹腔内出血或死亡率的显著差异.
- 对于早产婴儿,UCM为DCC提供了一个安全的替代方案,这些婴儿在出生时需要复苏.
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