Abstract:
BACKGROUND:To systematically evaluate short-term efficacy of UCM versus other interventions in preterm infants. METHODS:Six engines were searched until February 2020 for randomized controlled trials (RCTs) assessing UCM versus immediate cord clamping (ICC), delayed cord clamping (DCC), or no intervention. Primary outcomes were overall mortality, intraventricular hemorrhage (IVH), and patent ductus arteriosus (PDA); secondary outcomes were need for blood transfusion, mean blood pressure (MBP), serum hemoglobin (Hb), and ferritin levels. Random-effects meta-analyses were used. RESULTS:Fourteen RCTs (n = 1708) were included. In comparison to ICC, UCM did not decrease mortality (RR 0.5, 95% CI 0.2-1.1), IVH (RR 0.7, 95% CI 0.5-1.0), or PDA (RR 1.0, 95% CI 0.7-1.5). However, UCM reduced need of blood transfusion (RR 0.5, 95% CI 0.3-0.9) and increased MBP (MD 2.5 mm Hg, 95% CI 0.5-4.5), Hb (MD 1.2 g/dL, 95% CI 0.8-1.6), and ferritin (MD 151.4 ng/dL, 95% CI 59.5-243.3). In comparison to DCC, UCM did not reduce mortality, IVH, PDA, or need of blood transfusion but increased MBP (MD 3.7, 95% CI 0.6-6.9) and Hb (MD 0.3, 95% CI -0.2-0.8). Only two RCTs had high risk of bias. CONCLUSIONS:UCM did not decrease short-term clinical outcomes in comparison to ICC or DCC in preterm infants. Intermediate outcomes improved significantly with UCM. IMPACT:In 14 randomized controlled trials (RCTs), umbilical cord milking (UCM) did not reduce mortality, intraventricular hemorrhage, or patent ductus arteriosus compared to immediate (ICC) or delayed cord clamping (DCC).UCM improved mean blood pressure and hemoglobin levels compared to ICC or DCC. In comparison to ICC, UCM reduced the need for blood transfusion.We updated searches until February 2020, stratified by type of control, and performed subgroup analyses.There was low quality of evidence about clinical efficacy of UCM. Most of RCTs had low risk of bias.UCM cannot be recommended as standard of care for preterm infants.
journal_name
Pediatr Resjournal_title
Pediatric researchauthors
Barboza JJ,Albitres-Flores L,Rivera-Meza M,Rodriguez-Huapaya J,Caballero-Alvarado J,Pasupuleti V,Hernandez AVdoi
10.1038/s41390-020-0902-xsubject
Has Abstractpub_date
2020-04-21 00:00:00eissn
0031-3998issn
1530-0447pii
10.1038/s41390-020-0902-xpub_type
杂志文章,评审abstract:INTRODUCTION:In preterm neonates, peroxides contaminating total parenteral nutrition (TPN) contribute to oxidative stress, which is suspected to be a strong inducer of hepatic complications related to prematurity. Recently, others reported that hexapeptides derived from human milk (HM) exerted free radical-scavenging a...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2012.29
更新日期:2012-06-01 00:00:00
abstract::We studied the hemodynamic responses of 29 anesthetized and mechanically ventilated piglets to acute hypoxia [reduction of Pao2 from 130 to 38 mm Hg induced by inhalation of 7% fraction of inspired oxygen (Fio2) for 7.5 min] before and during group B beta-hemolytic streptococci (GBS) sepsis. During hypoxia, nonseptic ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200004000-00017
更新日期:2000-04-01 00:00:00
abstract::Severe tetrahydrobiopterin (BH4) deficiency is a naturally occurring model of cerebral catecholamine and serotonin shortage. Examination of the stimulated release and physiologic secretion pattern of several hormones in affected individuals permits certain conclusions concerning the involvement of these neurotransmitt...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199804000-00006
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:A growing body of evidence defines inflammation as a hallmark feature of disease pathogenesis of Duchenne muscular dystrophy. To tailor potential immune modulatory interventions, a better understanding of immune dysregulation in Duchenne muscular dystrophy is needed. We now asked whether dystrophin deficienc...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-019-0427-3
更新日期:2019-08-01 00:00:00
abstract::Disorders affecting fetal growth are commonly associated with premature birth. IGFs and their binding proteins (IGFBPs) are potent regulators of fetal growth. In vitro evidence suggests that they regulate collagen turnover. Collagen turnover can be monitored by serum markers of type I collagen synthesis (PINP) and deg...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200104000-00008
更新日期:2001-04-01 00:00:00
abstract::The aim of this study was to compare catecholamine concentrations in the fetal umbilical artery cord blood from the offspring of smokers versus the offspring of nonsmokers. Pregnant women who were self-identified as smokers (>/=10 cigarettes per day throughout pregnancy) or nonsmokers were recruited for study particip...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200301000-00020
更新日期:2003-01-01 00:00:00
abstract::Studies using stable isotopically labeled glucose and palmitate as precursors of pulmonary surfactant synthesis have demonstrated slow surfactant turnover in premature infants with respiratory distress syndrome (RDS). However, only limited data about surfactant turnover are available for term infants. Because acetate ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000075084.56255.E0
更新日期:2003-08-01 00:00:00
abstract::The antiendotoxin effect of polymyxin B was investigated in experimentally induced septicemia in rabbits. The Pasteurella multocida organisms were sensitive to the antibacterial action of penicillin but not to polymyxin B. Animals pre-treated with polymyxin showed positive blood cultures and significantly reduced plas...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197901000-00011
更新日期:1979-01-01 00:00:00
abstract::Patency of the ductus arteriosus in preterm infants is mediated by vasodilating prostanoids; however, reliable methods to monitor prostanoid activity or production in preterm infants are lacking. We measured the excretion rates of major and characteristic urinary metabolites of prostacyclin (PGI2), PGE1, and PGE2, 6-k...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198406000-00007
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Bradycardia and oxygen desaturation episodes are common among preterm very low birth weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU), and their association with adverse outcomes such as bronchopulmonary dysplasia (BPD) is unclear. METHODS:For 502 VLBW infants we quantified bradycardias (HR ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-018-0223-5
更新日期:2019-06-01 00:00:00
abstract::The effect of somatomedin and cortisol on embryonic chick cartilage in vitro indicates that somatomedin stimulates 35SO4 uptake while cortisol decreases it with no effect on glycosaminoglycan turnover. Xylosyltransferase activity is increased in crude fractions of somatomedin-treated cartilage but decreased in cortiso...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197902000-00002
更新日期:1979-02-01 00:00:00
abstract::The role of microbial colonization is indispensable for keeping a balanced immune response in life. However, the events that regulate the establishment of the microbiota, their timing, and the way in which they interact with the host are not yet fully understood. Factors such as gestational age, mode of delivery, envi...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1038/pr.2015.54
更新日期:2015-06-01 00:00:00
abstract::Nitric oxide (NO) serves many vasoprotective roles, but the massive release of NO causes arterial wall degeneration. We investigated whether enhanced nitric oxide synthase (iNOS) expression in peripheral blood leukocytes and circulating endothelial cells mirrors the progression of coronary arterial lesions in 55 child...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000113464.93042.A4
更新日期:2004-04-01 00:00:00
abstract::Several neuropathologic findings in infants and children with human immunodeficiency virus type-1 (HIV-1) infection are different from those observed in adults, probably related to the fact that the retroviral infection occurs in the setting of neuro-development. This report describes the interaction and biologic acti...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199511000-00025
更新日期:1995-11-01 00:00:00
abstract::Pulmonary hypoplasia has been associated with absent or hypoplastic pulmonary artery in four cases in humans. Despite these reports, the effects of decreased pulmonary arterial flow on fetal lung growth have not been adequately studied. This study defines the effects of left pulmonary artery (LPA) ligation on fetal lu...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199002000-00004
更新日期:1990-02-01 00:00:00
abstract::Tanshinone IIA is a compound purified from the Chinese herb Danshen (Radix Salviae Miltiorrhiza Bge). The neuroprotective effect of tanshinone IIA was investigated in a neonatal rat model of hypoxia-ischemia brain damage. Hypoxia-ischemia encephalopathy was induced in rats at day 7 of postnatal age by ligation of the ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000180550.99162.BC
更新日期:2005-10-01 00:00:00
abstract::Leukotrienes C4 and D4 and thromboxane A2 are potent vasoconstrictors that may mediate pulmonary vasoconstriction in many clinical situations. There is a complex interaction among leukotrienes and thromboxane A2, because inhibition of thromboxane synthesis prevents some of the hemodynamic effects of exogenous leukotri...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198908000-00001
更新日期:1989-08-01 00:00:00
abstract::To examine the mechanisms of autoregulatory impairment in meningitis, we studied the effects of Haemophilus influenzae type b (Hib) on pial vessels during hemorrhagic hypotension in rats, using a cranial window technique. We prepared cranial windows in barbiturate-anesthetized, mechanically ventilated rats. Artificial...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199301000-00010
更新日期:1993-01-01 00:00:00
abstract::After an initial postnatal diuresis, neonates are in positive sodium balance. Because atrial natriuretic peptide (ANP) contributes to sodium homeostasis, this study was designed to evaluate the maturational effects of increased dietary sodium intake on cardiac ANP production. Preweaned Sprague-Dawley rat pups were art...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199503000-00010
更新日期:1995-03-01 00:00:00
abstract::BackgroundPregnant women at a high risk of preterm delivery receive glucocorticoids to accelerate fetal lung maturation and surfactant synthesis. However, the effect of antenatal steroids on the developing diaphragm remains unclear. We hypothesized that maternal betamethasone impairs the fetal diaphragm, and the magni...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2017.99
更新日期:2017-09-01 00:00:00
abstract::Previous studies have shown that proton magnetic resonance spectroscopy (MRS) is useful in predicting neurologic prognosis in children with traumatic brain injury (TBI). Reductions in N-acetyl derived metabolites and presence of lactate have been predictive of poor outcomes. We examined another spectroscopy metabolite...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000139928.60530.7D
更新日期:2004-10-01 00:00:00
abstract::BackgroundSpecific HLA-DQ genes have been recognized as necessary - but not sufficient - factors for the occurrence of Celiac Disease (CD). Through a meta-analysis, evaluating the distribution of CD-related HLA genotypes in children, we aimed at providing insights for a potential widened screening strategy.MethodsAfte...
journal_title:Pediatric research
pub_type: 杂志文章,meta分析
doi:10.1038/pr.2017.307
更新日期:2018-03-01 00:00:00
abstract::To describe the relation between scalp blood flow and transcutaneous PO2 and PCO2, these three signals were recorded simultaneously in eight experiments on four healthy lambs in the first weeks after birth. Scalp blood flow was recorded by a laser Doppler flow sensor that was incorporated in the transcutaneous PO2 ele...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199005000-00005
更新日期:1990-05-01 00:00:00
abstract::Gitelman disease was diagnosed in two unrelated children with hypokalemic metabolic alkalosis and growth failure (a boy and a girl aged 7 mo and 9.5 y, respectively, at clinical presentation) on the basis of mutations detected in the gene encoding the thiazide-sensitive NaCl cotransporter of the distal convoluted tubu...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199908000-00017
更新日期:1999-08-01 00:00:00
abstract::Completely penetrant mutations in the surfactant protein B gene (SFTPB) and >75% reduction of SFTPB expression disrupt pulmonary surfactant function and cause neonatal respiratory distress syndrome. To inform studies of genetic regulation of SFTPB expression, we created a catalogue of SFTPB variants by comprehensive r...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e3180a03232
更新日期:2007-08-01 00:00:00
abstract::Kinetic data are presented for the decarboxylation of branched chain alpha-ketoacids (BCKA) by intact human fibroblasts. Cultured cells of normal individuals and nine patients with different clinical pictures of maple syrup urine disease (MSUD) are studied with both alpha-ketoisocaproic acid (2-oxo-4-methylpentanoic a...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-197509000-00005
更新日期:1975-09-01 00:00:00
abstract:INTRODUCTION:Corticosteroids have been widely used in clinical medicine as a first-line therapy to modify the inflammatory response in many pulmonary and systemic diseases. Inhaled and intratracheally administered corticosteroids have a particular interest in that their use allows the clinician to circumvent systemic s...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2011.78
更新日期:2012-04-01 00:00:00
abstract::Functional disturbances in microcirculation in juvenile type 1 diabetes (T1D) are believed to underlie, in part, the later occurrence of cardiovascular complications. Some epidemiologic studies suggested greater risk of microvascular complications in those with T1D-risk genotypes of human leukocyte antigen (HLA). We i...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/PDR.0b013e318165bfd4
更新日期:2008-04-01 00:00:00
abstract::LBW infants are at risk of iron deficiency (ID), which is associated with impaired nervous system development and may lead to prolonged auditory brainstem response (ABR) latencies. We hypothesized that iron supplementation shortens ABR latencies in marginally LBW (MLBW, 2000-2500 g) infants. In a randomized, controlle...
journal_title:Pediatric research
pub_type: 杂志文章,随机对照试验
doi:10.1203/PDR.0b013e3182320cd0
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Diseases of adulthood, such as diabetes and hypertension, may be related to changes during pregnancy, particularly in kidney. We hypothesized that acute kidney injury progresses more rapidly in cases of fetal programming. METHODS:Diabetic dams' offspring were divided into: CC (controls, receiving vehicle); ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2014.205
更新日期:2015-03-01 00:00:00