| Objective To identify the major risk factors in the development of anemia among premature infants in hospital,and investigate the impact of umbilical cord milking on the incidence of anemia in the premature infants.Methods The medical data of 163 premature infants admitted to department of neonatology from Janurary 2016 to December 2016 were retrospectively reviewed.All the infants born to mothers without prenatal complications were divided into two groups: anemia and non-anemia.The risk factors associated with anemia of prematurity were identified.Results(1)35 out of 163(21.4%)premature infants were diagnosed as anemia.the gestational age and birth weight of the anemia group were significantly lower than those of the non-anemia group(34.1±1.7weeks vs 35.4±1.2 weeks and 2220.6±393.91 g vs 2457.66±474.47 g,respectively;P<0.05).(2)The bloodloss from laboratory testing,the duration of hospital stay and the basal hemoglobin level were significantly higher than those of the non-anemia group(4.49 the f vs 2.80 the f and 16.43 uration of vs 11.27 uration of and 156.63±18.85 g vs 179.8±20.35 g,respectively;P<0.05).(3)Multiple factor logistic regression analysis revealed that anemia of prematurity was associated with blood loss from laboratory testing,duration of hospital stay,length of gestation and the basal hemoglobin level.Blood loss from laboratory testing is an independent risk-factor in the development of anemia among premature infants in hospital.Conclusions: Anemia of prematurity is associated with blood loss from laboratory testing,duration of hospital stay,length of gestation and the basal hemoglobin level.Blood loss from laboratory testing is an independent risk-factor in the development for anemia in premature infants.Objective: To investigate the impact of umbilical cord milking as compared with early cord clamping on hemoglobin,bilirubin and cardiac function in premature newborns.Methods: This was a randomized controlled trial performed from July to December 2017 on neonates born <37 weeks.Preterm newborns were randomly assigned to umbilical cord compression group(experiment group,n=41)or cord clamping within 10 seconds without compression(control group,n=37).Clinical measures of the outcomes were measured by hemoglobin at different periods,Transcutaneous Bilirubin in the first five days,the total hours of phototherapy,blood pressure,Left heart function within 72 hours,etc.Results:1.There were 78 premature infants involved in the experiment,41 infants in the experiment group and 37 infants in the control group.Compared with the control group,the first hemoglobin values in vein(186.24±17.30 g/L vs 170.41±22.44 g/L),were significantly higher in the experiment group,there were statistically significant differences(P<0.05).the experimental group after 3-5 days and 8-11 days 18-21 days and discharge hemoglobin were(170.10 ± 18.52 g/L vs 156.28 ± 19.80 g/L),(168.13 ± 17.99 g/L vs 143.41 ± 19.58 g/L),(157.07 ± 17.39 g/L vs 130.46 ± 15.80 g/L)at the same time the control group respectively,there were statistically significant differences between the two groups(P<0.05).But at the 4 months old postnatal hemoglobin were(111.25±7.92g/L vs 107.82±7.43g/L),the experiment group increased higher than in the control group,but there were no statistically significant difference(P>0.05).2.Compared with the control group,the daily transcutaneous bilirubin(umol/L)TCB1(64.52±28.76 VS 67.52±26.52),TCB2(158.53±33.34 vs 139.71±37.22),TCB3(217.46±37.84 vs 193.65±35.55),TCB4(230.31±31.54 vs 218.09±33.86),TCB5(232.27±33.11 vs 219.53±45.05),and the phototherapy time(34.24±29.34 hrs VS 32.76±38.95hrs),There were no significant difference between the two groups(P > 0.05),indicating that umbilical cord compression does not increase the risk of neonate jaundice.3.There was no significant difference between the two groups in terms of in left ventricular ejection fraction and left ventricular short axis shortening score within 72 hours after birth(66.38±5.75 vs 67.49±3.23)and(35.12±2.43 vs 36.06±3.52),(P > 0.05).This finding supports that umbilical cord compression does not increase the risk of cardiac insufficiency.Conclusions: 1.The umbilical cord extrusion at birth increases neonatal mean venous hematocrit within a physiologic range,can reduce the incidence of anemia at discharge,especially in the long hospital stay.2.The umbilical cord milking at birth does not increase the risk of cardiac insufficiency and hyperbilirubinemia.This practice has been shown to be safe. |
