Epidemiological Investigation On The Current Practice Of Umbilical Cord Clamping In China

Objective Umbilical cord clamping(UCC)is a routine clinical procedure after delivery of the fetus.It mainly includes immediate umbilical cord clamping(ICC),delayed umbilical cord clamping(DCC)and umbilical cord milking(UCM).DCC and UCM are two recently advocated interventions to enhance placental transfusion at birth,which might increase blood volume and help neonates to transition from fetal to neonatal circulation.The purpose of this study was to investigate the current situation of UCC after delivery and its influencing factors.Methods A anonymous web-based questionnaire on cord clamping practices was administered to midwives,obstetricians,and neonatologists in 126 hospitals selected in 16 provinces.The provinces were selected from seven different regions of China.Results A total of 5,005 questionnaires were finally received in this survey,among which 2,253 were midwives,1,541 were obstetricians and1,211 were neonatologists,accounting for 45.01%,30.79% and 24.20%,respectively,and the overall response rate of the questionnaire was 76.16%.The awareness rate of DCC among all respondents was 86.41%,while the clinical implementation rate of DCC was only 41.64%.The results of Logistic regression analysis showed that the main factors affecting the implementation of DCC were hospital type,hospital grade,factors of gestational age,mode of delivery,convenience of operation,department specification,prevention of hypothermia and convenience for asphyxia resuscitation(P<0.05).Compared with DCC,the awareness rate of respondents to UCM is low(60.16%),but the implementation rate is high(44.85%).According to the investigation,the main reason for the clinical implementation of UCM was that its convenient operation was conducive to the rescue of asphyxiation and the prevention of hypothermia in premature infants.Conclusion In this study,most of the respondents know about DCC and UCM through expert lectures and other ways.However,but because there is no guide or expert consensus for China’s national conditions,and also did not draw lessons from foreign guide clinical departments,leading to the clinical implementation of DCC and UCM affected by many factors,so it is necessary to establish clear guidelines or expert consensus in China to optimize the clinical practice.