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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Schwaberger, B; Ribitsch, M; Pichler, G; Krainer, M; Avian, A; Baik-Schneditz, N; Ziehenberger, E; Mileder, LP; Martensen, J; Mattersberger, C; Wolfsberger, CH; Urlesberger, B.
Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? - A randomized controlled trial.
Front Pediatr. 2022; 10:1005947 Doi: 10.3389/fped.2022.1005947 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Schwaberger Bernhard Christian
Co-Autor*innen der Med Uni Graz
Avian Alexander
Baik-Schneditz Nariae
Krainer Marlies
Martensen Johann
Mattersberger Christian
Mileder Lukas Peter
Pichler Gerhard
Ribitsch Mirjam
Urlesberger Berndt
Wolfsberger Christina H.
Ziehenberger Evelyn

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OBJECTIVES: To evaluate cerebral tissue oxygenation index (cTOI) during neonatal transition in a group of healthy full-term neonates receiving either a physiological-based approach of deferred cord clamping (CC) after the onset of stable regular breathing (PBCC group) or a standard approach of time-based CC < 1 min (control group). Secondary aim was to evaluate changes in cerebral blood volume (ΔCBV), peripheral arterial oxygen saturation (SpO2) and heart rate (HR) in those neonates. MATERIALS AND METHODS: We conducted a randomized controlled trial ( NCT02763436) including vaginally delivered healthy full-term neonates. Continuous measurements of cTOI and ΔCBV using near-infrared spectroscopy, and of SpO2 and HR using pulse oximetry were performed within the first 15 min after birth. Data of each minute of the PBCC group were compared to those of the control group. RESULTS: A total of 71 full-term neonates (PBCC: n = 35, control: n = 36) with a mean (SD) gestational age of 40.0 (1.0) weeks and a birth weight of 3,479 (424) grams were included. Median (IQR) time of CC was 275 (197-345) seconds and 58 (35-86) seconds in the PBCC and control group, respectively (p < 0.001). There were no significant differences between the two groups regarding cTOI (p = 0.319), ΔCBV (p = 0.814), SpO2 (p = 0.322) and HR (p = 0.878) during the first 15 min after birth. CONCLUSION: There were no significant differences in the course of cTOI as well as ΔCBV, SpO2 and HR during the first 15 min after birth in a group of healthy full-term neonates, who received either deferred CC after the onset of stable regular breathing or standard CC < 1 min. Thus, deferring CC ≥ 1 min following a physiological-based approach offers no benefits regarding cerebral tissue oxygenation and perfusion after uncomplicated vaginal delivery compared to a time-based CC approach.

Find related publications in this database (Keywords)
timing of cord clamping
neonatal transition
cerebral tissue oxygenation (index)
cerebral blood volume (CBV)
newborn infant
near-infrared spectroscopy
physiological-based cord clamping
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