Archives of disease in childhood. Fetal and neonatal edition · 2019
Randomised trial of cord clamping at very preterm birth: outcomes at 2 years.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Armstrong-Buisseret Lindsay, Powers Katie, Dorling Jon, Bradshaw Lucy, Johnson Samantha, Mitchell Eleanor, Duley Lelia
Аннотация
OBJECTIVE: To report outcomes at 2 years corrected age for children of women recruited to a trial comparing alternative policies for timing of cord clamping and immediate neonatal care at very preterm birth.
DESIGN: Parallel group randomised (1:1) trial.
SETTING: Eight UK tertiary maternity units.
PARTICIPANTS: Two hundred and seventy-six babies born to 261 women expected to have a live birth before 32+0 weeks' gestation.
INTERVENTIONS: Deferred cord clamping (≥2 min) and immediate neonatal care with cord intact or immediate (≤20 s) clamping and immediate neonatal care after clamping.
MAIN OUTCOME MEASURE: Composite of death or adverse neurodevelopmental outcome at 2 years corrected age.
RESULTS: Six babies born after 35+6 weeks were excluded. At 2 years corrected age, outcome data were not available for a further 52 children, leaving 218 for analysis (115 deferred clamping, 103 immediate clamping). Overall, 24/115 (21%) children allocated deferred clamping died or had an adverse neurodevelopmental outcome compared with 35/103 (34%) allocated immediate clamping; risk ratio (RR) 0.61 (95% CI 0.39 to 0.96); risk difference (RD) -13% (95% CI -25% to -1%). Multiple imputation for missing data gave an RR 0.69 (95% CI 0.44 to 1.09) and RD -9% (95% CI -21% to 2%).
CONCLUSIONS: Deferred clamping and immediate neonatal care with cord intact may reduce the risk of death or adverse neurodevelopmental outcome at 2 years of age for children born very premature. Confirmation in larger studies is needed to determine the real benefits and harms.
TRIAL REGISTRATION NUMBER: ISRCTN21456601.
DESIGN: Parallel group randomised (1:1) trial.
SETTING: Eight UK tertiary maternity units.
PARTICIPANTS: Two hundred and seventy-six babies born to 261 women expected to have a live birth before 32+0 weeks' gestation.
INTERVENTIONS: Deferred cord clamping (≥2 min) and immediate neonatal care with cord intact or immediate (≤20 s) clamping and immediate neonatal care after clamping.
MAIN OUTCOME MEASURE: Composite of death or adverse neurodevelopmental outcome at 2 years corrected age.
RESULTS: Six babies born after 35+6 weeks were excluded. At 2 years corrected age, outcome data were not available for a further 52 children, leaving 218 for analysis (115 deferred clamping, 103 immediate clamping). Overall, 24/115 (21%) children allocated deferred clamping died or had an adverse neurodevelopmental outcome compared with 35/103 (34%) allocated immediate clamping; risk ratio (RR) 0.61 (95% CI 0.39 to 0.96); risk difference (RD) -13% (95% CI -25% to -1%). Multiple imputation for missing data gave an RR 0.69 (95% CI 0.44 to 1.09) and RD -9% (95% CI -21% to 2%).
CONCLUSIONS: Deferred clamping and immediate neonatal care with cord intact may reduce the risk of death or adverse neurodevelopmental outcome at 2 years of age for children born very premature. Confirmation in larger studies is needed to determine the real benefits and harms.
TRIAL REGISTRATION NUMBER: ISRCTN21456601.