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True umbilical cord knot and obstetric outcome
Author(s) -
Räisänen Sari,
Georgiadis Leena,
Harju Maija,
KeskiNisula Leea,
Hein Seppo
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.02.012
Subject(s) - medicine , umbilical cord , obstetrics , apgar score , gestational age , birth weight , small for gestational age , fetus , population , incidence (geometry) , pregnancy , physics , environmental health , anatomy , biology , optics , genetics
Objective To identify risk factors for true umbilical cord knot and to evaluate its association with fetal death, premature birth, low birth weight, small‐for‐gestational‐age (SGA) infants, low Apgar score at 1 and 5 minutes, fetal venous pH of 7.15 or lower, and need for neonatal intensive care in singleton pregnancies. Methods The total population of women who delivered at Kuopio University Hospital, Kuopio, Finland, between January 2000 and August 2012 was reviewed. Risk factors for umbilical cord knot and its association with adverse pregnancy outcome were evaluated separately among women with and without true cord knot via logistic regression analysis. Results Overall, 340 (1.2%) of 27 537 singleton pregnancies were affected by umbilical cord knot, with increased incidence associated with advanced maternal age, multiparity, previous spontaneous abortion, polyhydramnios, and diabetes mellitus. Umbilical cord knot was associated with a 1.58‐, 8.08‐, 3.90‐, 3.17‐, 1.67‐, and 2.00‐fold increased risk of neonatal intensive care, fetal death, premature birth, SGA infants, and low Apgar score at 1 and 5 minutes, respectively. Conclusion True umbilical cord knot is relatively common and is associated with increased incidence of SGA infants, premature birth, need for neonatal intensive care, and fetal death.