Association of delayed cord clamping with acute kidney injury and two-year kidney outcomes in extremely premature neonates: a secondary analysis of the preterm erythropoietin neuroprotection trial (PENUT).

Autor: Zapata HA; University of Florida College of Medicine Jacksonville, Division of Neonatology, Jacksonville, FL, USA., Todurkar N; University of British Columbia, Department of Pediatrics, Vancouver, BC, Canada., Favel K; University of California San Francisco, Division of Pediatric Nephrology, San Francisco, CA, USA., Griffin RL; University of Alabama Birmingham, Department of Epidemiology, Birmingham, AL, USA., Starr MC; Indiana University School of Medicine, Division of Pediatric Nephrology, Indianapolis, IN, USA., Charlton JR; University of Virginia, Department of Pediatrics, Charlottesville, VA, USA., McAdams RM; University of Wisconsin, Division of Neonatology, Madison, WI, USA., Askenazi D; University of Alabama Birmingham, Department of Pediatrics, Birmingham, AL, USA., Kulkarni T; University of British Columbia, Department of Pediatrics, Vancouver, BC, Canada., Menon S; Stanford University, Department of Pediatrics, Division of Pediatric Nephrology, Palo Alto, CA, USA., Mammen C; University of British Columbia, Department of Pediatrics, Vancouver, BC, Canada., Harer MW; University of Wisconsin, Division of Neonatology, Madison, WI, USA. mwharer@wisc.edu.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2024 Oct 11. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1038/s41372-024-02143-7
Abstrakt: Background: Delayed cord clamping (DCC) occurs in most preterm births.
Objective: Evaluate the association of DCC with acute kidney injury (AKI) and two-year kidney outcomes.
Methods: Secondary analysis of the Preterm Erythropoietin Neuroprotection Trial of neonates born 24 0/7 to 27 6/7 weeks gestation. AKI and two year kidney outcomes were compared in neonates with DCC ( ≥ 30 s after delivery) to those with early cord clamping (ECC) (<30 s after delivery).
Results: The incidence and severity of AKI did not differ between the DCC and ECC groups (aOR 1.17 [95%CI 0.76-1.80]). At two years corrected age, DCC was associated with a 4.5-fold increased adjusted odds of estimated glomerular filtration rate (eGFR) <90 mL/min/1.73m 2 . No significant associations were noted between DCC and albuminuria or elevated blood pressure.
Conclusions: DCC was not associated with decreased neonatal AKI, but was associated with higher adjusted odds of eGFR <90 mL/min/1.73m 2 at two years.
(© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
Externí odkaz: