| ObjectiveTo investigate the effects of different policies of timing of umbilical cord clamping and the position of the placenta in relation to the newborn, on jaundice of newborn infant with term delivery at the first day, second day, third day, forth day and fifth day after delivery. Compare percutaneous bilirubin value with different policies of timing of cord clamping and the position of the placenta in relation to the newborn. Study delaying umbilical cord ligation to increase the risk of jaundice.Provide the important evidence for the proper time of clamping cord and the placement of the newborn.MethodsSingleton full-term and healthy pregnant women giving birth and her neonate in department of gynecology and obstetrics at Second Hospital of Shandong University from July,2012until December,2012, meeting the inclusion criteria were analyzed. The inclusion criteria included:①full-term pregnancy;②maternal age between20and35years;③no pathological pregnancy(hypertensive disorders in pregnancy; gestational diabetes mullites,GDM;placenta previa;placental abruption;fetal death);④no medical and surgical diseases;⑤spontaneous labor;⑥parents gave written consent. Exclusive criteria:①newborn malformation, such as congenital biliary atresia;②placental abnormality,such as placenta cirumvallate;③Apgar’s scores<7in1minute;④other disorders leading to pathologic jaundice,such as infection,hemolytic disease of newborn(HDN);⑤parents refused consent.Infants were randomized to A,B,C groups.Group A was the placenta, the newborn and the cord in a horizontal plan;group B was the newborn lower than the placenta. According to the time of umbilical cord clamping(delaying30s, lmin,2min and3min),group A and B were divided into A1,A2,A3,A4and B1,B2,B3,B4.In group C,cord clamping was at<15s imrnediately.Measure percutaneous bilirubin of newborn infants at the first day, second day, third day, forth day and fifth day after delivery. Measure serum bilirubin to examine the diagnosis if the percutaneous bilirubin value was greater than12.9milligrams per deciliter.Finally, the278remaining were randomized into this analyzation. All the data were analyzed by SPSS17.0system with methods of t-test, one-way ANOVA, and χ2analyses. We defined that statistical significance existed when P value less than0.05.Results1Different policies of timing of cord clamping on jaundice of newborn infant①Group A:When the placenta, the newborn and the cord in a horizontal plan, no significant difference of percutaneous bilirubin of newborn infants existed between different timing of cord clamping group(P=0.202, P>0.05).The differences of percutaneous bilirubin on the first to fifth day were significant (P=0.000, P<0.05).There was no interaction between measuring time and timing of cord clamping(P=0.199, P>0.05).任Group B:When the newborn was located10cm below the placenta, no significant difference of percutaneous bilirubin of newborn infants existed between different timing of cord clamping group(P=0.438, P>0.05).The differences of percutaneous bilirubin on the first to fifth day were significant (P=0.000, P<0.05).There was no interaction between measuring time and timing of cord clamping(P=0.310, P>0.05).2Group A and B:Different policies of the position of the placenta in relation to the newborn,on jaundice of newborn infantNo significant difference of percutaneous bilirubin of newborn infants existed between different position group(P=0.132, P>0.05).The differences of percutaneous bilirubin on the first to fifth day were significant (P=0.000, P<0.05).There was no interaction between measuring time and the position of the placenta in relation to the newborn(P=0.361, P>0.05).3Trend analysis of percutaneous bilirubin concentrationThe bilirubin concentration trends of the A1-A4, B1-B4and C group were all:there is a gradually increasing concentration from the first day with minimum percutaneous bilirubin concentration, then the trend on the decline after the forth day with peak concentration.4Interaction of delaying cord clamping and position of the placenta in relation to the newbornThere was no interaction between delaying cord clamping and position of the placenta in relation to the newborn on percutaneous bilirubin, according to no significant difference of percutaneous bilirubin of newborn infants between different timing of cord clamping groups and no significant difference between both position groups.5Pathologic jaundice incidence of different timing of cord clamping groups and both position groupsIn the five days after childbirth, pathologic jaundice incidences were:the Al group43.3%,the A2group55.2%,the A3group56.3%,the A4group28.6%,the B1group50.0%,the B2group46.2%,the B3group44.4%,the B4group38.7%,the C group38.2%.No significant difference of incidences of newborn infants existed (P=0.495, P>0.05).Conclusion1. Different policies of time of cord clamping or the position of the placenta in relation to the newborn did not increase jaundice of newborn infant with term delivery.2. Different policies of timing of cord clamping or the position of the placenta in relation to the newborn, did not change the trend of percutaneous bilirubin concentration of newborn infant with term delivery. The trends were all:there is a gradually increasing concentration from the first day with minimum percutaneous bilirubin concentration, then the trend on the decline after the forth day with peak concentration.3. There was no interaction between delaying cord clamping and position of the placenta in relation to the newborn on percutaneous bilirubin.SignificanceWe investigated the effects of different policies of time of cord clamping and the position of the placenta in relation to the newborn, on jaundice of newborn infant with term delivery at the first day, second day, third day, forth day and fifth day after delivery.The risk of newborn jaundice did not increase by delaying cord clamping and changing position of the placenta in relation to the newborn. To prevent anemia of the newborn and increase the number of stem cells in newborn infant, delaying cord clamping in3min was practicable at the same time not to increase the risk of jaundice. newborn could be placed lower than the placentas during the delaying time. |
PDF Full Text Request