| Objective To investigate the related factors of anemia in premature infants,and to provide evidence to prevent and treat the anemia of preterm infants.To explore the effect of umbilical cord clamping at different timing after delivery on hemoglobin and iron reserve of preterm infants,in order to find the ideal clamping time for preterm infants.Methods(1)200 premature neonates delivered in Jiangning Hospital from June 2015 to April 2018 were selectedretrospectively.Clinicaldata were collected including the incidence of 12-month anemia in preterm infants,and the risk factors of anemia of preterm infant.(2)107 preterm infants were selected and divided into control group(48 cases)and observation group(59 cases).The control group clamped the umbilical cord at 1 minute after delivery,while the observation group clamping the umbilical cord at 3 minutes after birth or after the umbilical artery stopped beating.The hemoglobin(Hb)and serum ferritin(SF)were compared between the two groupsat umbilical cord and 24-48 h,42 d and 4 months after birth,and iron deficiency anemia(IDA)incidence was collected during the observation period.Result(1)Among the 200 premature infants selected,the incidence of anemia was 31.00%.There were 62 premature infants in anemia group,30 males and 32 females.There were 138 premature infants in non-anemia group,73 males and 65 females.In anemia group,mean gestational age of was 33.51 ± 4.57 weeks,meanbirth weight was 2.24±0.15 kg,47 patients receivedmechanical ventilation,hospitalization time was 12.16±2.57 days,iatrogenic blood lose was 12.65 ±2.34 ml,exclusive breast-feeding was performed in 44 cases,mixed feeding in 18 cases,direct umbilical cord clamping in 51 cases,delayed umbilical cord ligation in 11 cases,basal Hb value was 162.59±17.52 g/L,and maternal anemia in 22 cases.In the non-anemia group,the gestational age of preterm infants was 35.12±4.64 weeks,birth weight was 2.46±0.21 kg,mechanical ventilation was performed in 51 cases,hospitalization time was 10.24±2.38 days,iatrogenic blood lose was 9.82±2.16 ml,exclusive breast-feeding was performed in 77 cases,mixed feeding in 61 cases,direct umbilical cord clamping in 56 cases,delayed umbilical cord clamping in 82 cases,basic Hb value was 177.55±18.41 g/L,and maternal anemia in 29 cases.Univariate analysis showed that gestational age,birth weight,mechanical ventilation,hospitalization time,iatrogenic blood lose,feeding patterns,umbilical cord clamping timing,basic Hb level and maternal anemia,had significant differences(p < 0.05)between the anemic and non-anemicgroups.Logistic regression analysis showed that gestational age,birth weight,delayumbilical cord clamping,Hb level at birth were protective factors for preterm infants with anemia,while hospitalization time,iatrogenic blood lose,maternal anemia and feeding patterns were independent risk factors for preterm infants with anemia.(2)The Hblevel at birth and 24-48 hours of life in the observation group was significantly higher than in the control group(167.53 ± 9.18 g/L vs 161.85 ±9.24 g/L,183.51 ±11.69 g/L vs 176.39 ±10.26 g/L,P< 0.05),but there was no significant difference between the two groups at 42 days and 4 months of life(P> 0.05).There was no significant difference in SF level between the two groups at the time of umbilical cord clamping and 24-48 hours of life(P > 0.05).The SF level of the observation group at 42 days and 4 months was higher than the control group with significantdifference(142.54 ±25.37 ng/ml vs 128.63 ±21.58 ng/ml,103.26 ±22.38 ng/ml vs 87.38 ± 18.94 ng/ml,P< 0.01).The incidence of IDA in preterm infants in the observation group was 11.86% lower than that in the control group 27.08% with significantdifference(P < 0.05).Conclusion(1)Anemia ofpreterm infants has a high incidence.The independent risk factors for anemia ofpreterm infants are gestational age(smaller),birth weight(lighter),basic Hb value at birth(smaller),length of hospital stay(longer),iatrogenic blood lose amount(larger),maternal anemia and feeding patterns(breast feeding).(2)3 minutes delayed cord clamping or after cessation of umbilical artery pulsation are recommended for preterm infants,which can significantly improve early Hb level and iron reserve and prevent IDA. |
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