延迟断脐对足月新生儿黄疸的影响研究

Study on Effect of Delayed Umbilical Cord Cutting on Jaundice of Full-Term Neonates

目的:探讨延迟断脐对足月新生儿黄疸的影响。方法:选取2018年10月—2021年12月天津和平新世纪妇儿医院单胎足月分娩的287例新生儿作为研究对象,根据娩出方式不同分为阴道分娩组与剖宫产组;再根据胎儿娩出后脐带结扎时机分为早断脐组与延迟断脐组。两组均检测经皮胆红素浓度,比较两个亚组经皮胆红素浓度以及高胆红素血症发生率。结果:出生1、3 d,阴道分娩早期断脐组与阴道分娩延迟断脐组经皮胆红素浓度比较,差异无统计学意义(P>0.05);出生2 d,阴道分娩延迟断脐组经皮胆红素浓度高于阴道分娩早期断脐组,差异有统计学意义(P=0.010)。出生1、2、3 d,剖宫产早期断脐组经皮胆红素浓度高于剖宫产延迟断脐组,差异有统计学意义(P=0.000)。出生3 d内,阴道分娩早断脐处理组与阴道分娩延迟断脐组高胆红素血症发生率比较,差异无统计学意义(P>0.05);剖宫产早断脐处理组与剖宫产延迟断脐组高胆红素血症发生率比较,差异无统计学意义(P>0.05)。结论:阴道分娩、剖宫产中延迟断脐60~90 s应用于单胎足月新生儿中,不会提高新生儿黄疸风险。

Objective:To investigate the effect of delayed umbilical cord cutting on jaundice in full-term neonates.Methods:A total of 287 singleton full-term newborns delivered in Tianjin Heping New Century Women's and Children's Hospital from October 2018 to December 2021 were selected as the study subjects.According to their delivery methods,they were divided into vaginal delivery group and cesarean section group;According to the time points of umbilical cord ligation after delivery,they were further divided into early umbilical cord cutting group and delayed umbilical cord cutting group.Transcutaneous bilirubin concentrations were measured in both groups.Transcutaneous bilirubin concentrations and the incidence of hyperbilirubinemia were compared between the two subgroups.Results:At 1 d and 3 d after birth,there was no significant difference in the transcutaneous bilirubin concentration between the early umbilical cord cutting group and the delayed umbilical cord cutting group of vaginal delivery(P>0.05).At 2 d after birth,the transcutaneous bilirubin concentration in the delayed umbilical cord cutting group of vaginal delivery was higher than that in the early umbilical cord cutting group of vaginal delivery,with statistically significant difference(P=0.010).At 1,2 and 3 d after birth,the transcutaneous bilirubin concentration in the early umbilical cord cutting group was higher than that in the delayed umbilical cord cutting group of cesarean section,with statistically significant difference(P=0.000).Within 3 d after birth,there was no significant difference in the incidence of hyperbilirubinemia between the early umbilical cord cutting group and the delayed umbilical cord cutting group of vaginal delivery(P>0.05).There was no significant difference in the incidence of hyperbilirubinemia between the early umbilical cord cutting group and the delayed umbilical cord cutting group of cesarean section(P>0.05).Conclusion:Delayed umbilical cord cutting for 60-90 s in singleton full-term newborns of vaginal delivery and cesarean section will not increase jaundice risk in full-term neonates.