Effect of Placental Transfusion on Iron Stores in Moderately Preterm Neonates of 30-33 weeks Gestation

被引:17
作者
Das, Bikramjit [1 ]
Sundaram, Venkataseshan [1 ,2 ]
Kumar, Praveen [1 ]
Mordi, William T. [3 ]
Dhaliwal, Lakhbir K. [4 ]
Das, Reena [5 ]
机构
[1] Postgrad Inst Med Educ & Res, Dept Pediat, Neonatal Unit, Chandigarh, India
[2] Postgrad Inst Med Educ & Res, Dept Pediat, Newborn Unit, Chandigarh 160012, India
[3] Univ Sydney, NHMRC Clin Trials Ctr, WINNER Ctr Newborn Res, Sydney, NSW, Australia
[4] Postgrad Inst Med Educ & Res, Dept Obstet & Gynecol, Neonatal Unit, Chandigarh, India
[5] Postgrad Inst Med Educ & Res, Dept Hematol, Neonatal Unit, Chandigarh, India
关键词
Placental transfusion; Delayed cord clamping; Early cord clamping; Cord milking; Ferritin; Iron deficiency; Moderately preterm; Neonate; UMBILICAL-CORD MILKING; DEFICIENCY ANEMIA; INFANTS;
D O I
10.1007/s12098-017-2490-2
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To assess the effect of placental transfusion by delayed cord clamping (DCC) of 60 s or cord milking (CM) on serum ferritin levels at hospital discharge and 3 mo of postmenstrual age (PMA) in preterm neonates of 30 to 33 wk gestation in comparison to early cord clamping (ECC) within 10 s. Methods This mixed longitudinal study was conducted in moderately preterm neonates of 30 to 33 wk gestation born in a level III unit in Northern India with the study sample nested within a randomized controlled trial on placental transfusion. Intervention was delayed cord clamping for 60 s or cord milking compared with early cord clamping (within 10 s). Primary outcome measure was serum ferritin levels at discharge. Secondary outcome measures were serum ferritin levels at 3 mo PMA, incidence of anemia, need for blood transfusion and incidence of iron deficiency by 3 mo PMA. Results Out of the 215 randomly chosen infants, serum ferritin levels were estimated at least at one time point (at discharge or at 3 mo PMA) in 197 neonates [placental transfusion - 107; early cord clamping - 90]. Amongst them, ferritin level was estimated at discharge in 141 neonates, at 3 mo PMA in 76 neonates and at both time points in 20 neonates. Median (IQR) serum ferritin (mu g/L) at discharge was significantly higher in placental transfusion group in comparison to the ECC group [399 (309,600) (n = 79) vs. 254 (190,311) (n = 62); p < 0.001]. Median (IQR) ferritin level at 3 mo PMA was not different between the study groups [20 (14,57) (n = 39) vs. 24 (8,52) (n = 37); p = 0.2]. The incidence of anemia by 3 mo PMA was significantly lesser in the placental transfusion group. No difference was observed in anemia requiring blood transfusion and iron deficiency by 3 mo PMA between the groups. Conclusions In 30 to 33 wk preterm neonates, placental transfusion resulted in significantly higher serum ferritin at discharge in comparison to early cord clamping. However, this benefit did not persist till 3 mo PMA.
引用
收藏
页码:172 / 178
页数:7
相关论文
共 20 条
[11]   Iron-deficiency anemia and infant development: Effects of extended oral iron therapy [J].
Lozoff, B ;
Wolf, AW ;
Jimenez, E .
JOURNAL OF PEDIATRICS, 1996, 129 (03) :382-389
[12]  
Lozoff Betsy, 2006, Semin Pediatr Neurol, V13, P158, DOI 10.1016/j.spen.2006.08.004
[13]  
Lubin BH, 1981, HEMATOLOGY INFANCY C, P1552
[14]   Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes [J].
McDonald, Susan J. ;
Middleton, Philippa ;
Dowswell, Therese ;
Morris, Peter S. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2013, (07)
[15]  
OSKI FA, 1993, NEW ENGL J MED, V329, P190, DOI 10.1056/NEJM199307153290308
[16]   Part 11: Neonatal Resuscitation 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations [J].
Perlman, Jeffrey M. ;
Wyllie, Jonathan ;
Kattwinkel, John ;
Atkins, Dianne L. ;
Chameides, Leon ;
Goldsmith, Jay P. ;
Guinsburg, Ruth ;
Hazinski, Mary Fran ;
Morley, Colin ;
Richmond, Sam ;
Simon, Wendy M. ;
Singhal, Nalini ;
Szyld, Edgardo ;
Tamura, Masanori ;
Velaphi, Sithembiso .
CIRCULATION, 2010, 122 (16) :8516-8538
[17]   Effect of Early versus Delayed Cord Clamping on Hematological Status of Preterm Infants at 6 wk of Age [J].
Ranjit, Thomas ;
Nesargi, Saudamini ;
Rao, P. N. Suman ;
Sahoo, Jagdish Prasad ;
Ashok, C. ;
Chandrakala, B. S. ;
Bhat, Swarnarekha .
INDIAN JOURNAL OF PEDIATRICS, 2015, 82 (01) :29-34
[18]  
SAIGAL S, 1972, PEDIATRICS, V49, P406
[19]   ERYTHROPOIETIN AND NEONATAL ANEMIA [J].
STRAUSS, RG .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 330 (17) :1227-1228
[20]   Delayed cord clamping in preterm infants delivered at 34-36 weeks' gestation: a randomised controlled trial [J].
Ultee, C. A. ;
Van der Deure, J. ;
Swart, J. ;
Lashann, C. ;
Van Baar, A. L. .
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION, 2008, 93 (01) :F20-F23