Effect of DCC on Neonatal Jaundice and Blood Gas Analysis in Infants Born to GDM Mothers

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Вход / Регистрация

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СъстояниеНабиране

Спонсори

Second Affiliated Hospital of Wenzhou Medical University

КЛИНИЧНО ИЗСЛЕДВАНЕ: NCT04369313

BioSeek: nct04369313

Ключови думи

Резюме

Evidence for benefited newborns following delayed cord clamping (DCC), including increasing hemoglobin and hematocrit levels, improving iron stores, and decreasing need for blood transfusion and incidence of intraventricular hemorrhage, in term or preterm infants led the American College of Obstetricians and Gynecologists (ACOG) to recommend a delayed cord clamping at least 30-60 seconds in vigorous term and preterm infants at birth. Although DCC has been found to be beneficial to infants, the additional blood provided by DCC could increase the incidence of jaundice that requires phototherapy and the hyperbilirubinemia, and the time prolonged by DCC might jeopardize timely resuscitation efforts, if needed. The acid-base status in umbilical cord blood at birth reflects the newborn's aerobic and anaerobic intrauterine metabolisms and is an objective measure of the fetal exposure and response to hypoxia during labour.

Gestational diabetes mellitus (GDM) is a condition in which glucose intolerance develops during pregnancy. It has been estimated in 2009 that nearly 7% of pregnancies are complicated by diabetes and approximately 86% of these cases represented women with GDM. The Hyperglycemia and Adverse Pregnancy Outcome study (HAPO) revealed that the infants of diabetic mothers (IDMs) are at increased risk of neonatal hypoglycemia, hyperbilirubinemia, shoulder dystocia, and birth trauma. And newborns to diabetic mothers are at increased risk of neonatal respiratory distress syndrome (RDS) and hypoxia, a major cause of admission in neonatal intensive care units. There is little direct evidence on the implementation of delayed umbilical cord clamping in the risk group of IDMs. Therefore, it no clear that the effectiveness and impairment of DCC in IDMs.

Therefore, the investigators conducted a prospective study in performing DCC in the infants of diabetic mothers versus the newborns with early cord clamping (ECC) to assess the effect of DCC on neonatal bilirubin levels, hyperbilirubinemia incidence, acid-base status and hypoxia in IDMs.

Дати

Последна проверка:	04/30/2020
Първо изпратено:	04/26/2020
Очаквано записване подадено:	04/28/2020
Първо публикувано:	04/29/2020
Изпратена последна актуализация:	05/10/2020
Последна актуализация публикувана:	05/12/2020
Действителна начална дата на проучването:	08/31/2019
Приблизителна дата на първично завършване:	06/30/2020
Очаквана дата на завършване на проучването:	08/31/2020

Състояние или заболяване

Gestational Diabetes Mellitus

Neonatal Hyperbilirubinemia

Neonatal Asphyxia

Интервенция / лечение

Procedure: delayed cord clamping

Procedure: early cord clamping

Фаза

Групи за ръце

Arm	Интервенция / лечение
Experimental: delayed cord clamping clamping the cord at least 30s at birth	Procedure: delayed cord clamping umbilical cord clamping more than 30 seconds after birth
Other: early cord clamping umbilical cord clamping before 15 seconds	Procedure: early cord clamping umbilical cord clamping within 15 seconds after birth

Критерии за допустимост

Възрасти, отговарящи на условията за проучване	18 Years Да се 18 Years
Полове, допустими за проучване	Female
Приема здрави доброволци	Да
Критерии	Inclusion Criteria: People in the study should meet the following inclusion criteria: - Must be a singleton pregnancy - Clinical diagnosis of gestational diabetes mellitus according to ACOG Practice Bulletin Exclusion Criteria: - Pregnant women and neonates were excluded if they met the exclusion criteria (not included in if meeting one of following items ) - Maternal clinical diseases (hypertension disorders, abnormal liver function, Rhesus negative blood group or other blood system disease) - Maternal other pregnancy complications (polyhydramnios, oligohydramnios, placenta praevia, and abruptio placentae). - Delivery before 37 weeks or after 42 weeks - Neonatal weight was < 2.5 kg or>4.0 kg - Neonates had major congenital malformations (congenital anal atresia, congenital biliary atresia, congenital heart disease and so on, whether prenatal suspicion or diagnosis postpartum) - Neonatal septicemia, hemolytic disease or other diseases affecting bilirubin metabolism.

Резултат

Първични изходни мерки

1. neonatal transcutaneous bilirubin level [within the 1 to 3 days of age]

The transcutaneous bilirubin was measured by the uniform TcB device three times a day

2. Number of infants with neonatal jaundice requiring phototherapy [within the 1 to 3 days of age]

the infants need phototherapy because of high bilirubin level

3. Number of infants with neonatal hyperbilirubinemia [within the 1 to 3 days of age]

the infants need phototherapy because of high bilirubin level

4. neonatal cord acid-base status [within the 15 minutes after delivery]

arterial cord samples were analyzed within 15 min by blood gas analyzer

Вторични изходни мерки

1. neonatal initial blood glucose levels [within the 30 minutes after delivery]

The initial blood glucose levels were measured within 30 minutes after birth and before breastfeeding

Effect of DCC on Neonatal Jaundice and Blood Gas Analysis in Infants Born to GDM Mothers

Ключови думи

хипоксия

кръвоизлив

жълтеница

захарен диабет

хипергликемия

хипогликемия

shoulder dystocia