Objective To analyze the differences of hemoglobin, bilirubin and related complications between umbilical cord milking (ICM) and immediate cord clamp (ICC), in order to provide clinical evidence for cord-cutting in premature infants born at less than 34 weeks of gestation.Methods The clinical data of 115 cases of premature infants born at less than 34 weeks of gestation and delivered via vaginal were analyzed retrospectively. The infants were divided into UCM group (n=59) and ICC group (n=56) according to cord milking method. Hemoglobin change trend, blood transfusion volume, percutaneous bilirubin value and phototherapy time during hospitalization were compared between infants in UCM group and ICC group. Besides, the prevalence rates of intracranial hemorrhage, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) and necrotizing enterocolitis (NEC) were also compared.Results The hemoglobin level of infants in the UCM group were higher than that in the ICC group within 1 h after birth, about 1 week after birth and before discharge (t=2.246, 2.123, 1.886, P＜0.05). The frequency and volume of blood transfusions for premature infants in the ICC group were higher than those in the UCM group during hospitalization (χ2=2.145, t=2.160, P＜0.05). The peak time of transcutaneous bilirubin in the two groups both ranged from 3 to 6 days. During this period, the value of transcutaneous bilirubin of infants in the UCM group was significantly higher than that in the ICC group(t=2.231, 2.654, 2.686, 2.038, P＜0.05), but there was no significant difference in the duration of phototherapy between the two groups (P＞0.05). The occurrence of complications such as intracranial hemorrhage, ROP, BPD and NEC during the hospitalization was all no significantly different between the two groups (P＞0.05).Conclusions Compared with conventional umbilical cord amputation, umbilical cord milking can increase the blood volume and hemoglobin content, reduce the frequency and volume of blood transfusions during hospitalization, and do not increase pathological jaundice and complications in preterm infants with gestational age ＜34 weeks. Therefore, umbilical cord milking can be used as the first choice for premature infants with gestational age ＜34 weeks.
Key words
umbilical cord milking /
premature infants /
hemoglobin /
jaundice
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