Increased risk of bradycardia in vigorous infants receiving early as compared to delayed cord clamping at birth.

Autor: Kc A; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. ashish.k.c@kbh.uu.se., Kong SYJ; Laerdal Medical, Stavanger, Norway., Haaland SH; Laerdal Medical, Stavanger, Norway., Eilevstjønn J; Laerdal Medical, Stavanger, Norway., Myklebust H; Laerdal Medical, Stavanger, Norway., Bastola RC; Pokhara Academy of Health Sciences, Pokhara, Nepal., Wood TR; Center on Human Development and Disability, University of Washington, Seattle, WA, USA., Niermeyer S; University of Colorado School of Medicine, Colorado School of Public Health, Aurora, CO, USA., Berkelhamer S; Department of Pediatrics, University of Washington, Seattle, WA, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2023 Jun; Vol. 43 (6), pp. 709-715. Date of Electronic Publication: 2022 Dec 31.
DOI: 10.1038/s41372-022-01593-1
Abstrakt: Objective: To compare HR pattern of vigorous newborns during the first 180 s with early (≤60 s, ECC) or delayed (>60 s, DCC) cord clamping.
Study Design: Observational study including dry-electrode ECG monitoring of 610 vaginally-born singleton term and late-preterm (≥34 weeks) who were vigorous after birth.
Results: 198 received ECC while 412 received DCC with median cord clamping at 37 s and 94 s. Median HR remained stable from 30 to 180 s with DCC (172 and 170 bpm respectively) but increased with ECC (169 and 184 bpm). The proportion with bradycardia was higher among ECC than DCC at 30 s and fell faster in the DCC through 60 s. After adjusting for factors affecting timing of cord clamping, ECC had significant risk of bradycardia compared to DCC (aRR 1.51; 95% CI; 1.01-2.26).
Conclusion: Early heart instability and higher risk of bradycardia with ECC as compared to DCC supports the recommended clinical practice of DCC.
(© 2023. The Author(s).)
Databáze: MEDLINE
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