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Incidence and risk factors for velamentous umbilical cord insertion in singleton pregnancies after assisted reproductive technology
Author(s) -
Furuya Satoshi,
Kubonoya Kiyoshi,
Yamaguchi Takashi
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14727
Subject(s) - medicine , intracytoplasmic sperm injection , obstetrics , blastocyst transfer , assisted reproductive technology , gynecology , embryo transfer , umbilical cord , odds ratio , in vitro fertilisation , placenta previa , incidence (geometry) , pregnancy , advanced maternal age , blastocyst , placenta , fetus , embryo , infertility , biology , embryogenesis , genetics , physics , anatomy , optics , microbiology and biotechnology
Aim Assisted reproductive technology (ART) is gaining popularity worldwide. However, it is associated with increased incidence of velamentous umbilical cord insertion (VCI) in the placenta, resulting in adverse perinatal outcomes. This study aimed to identify the risk factors that might affect the incidence of VCI in pregnancies after ART treatment. Methods We retrospectively analyzed the records of 906 singleton pregnancies via ART; all women delivered in our facility. Three ART‐related variables and infant sex were examined: (1) fertilization method (conventional in vitro fertilization or intracytoplasmic sperm injection), (2) type of embryo at the time of transfer (fresh or frozen–thawed), (3) developmental stage of embryo at the time of transfer (cleavage stage or blastocyst), and (4) infant sex (male or female). Logistic regression analysis was used to assess the impact of these variables on the incidence of VCI. Results Of 906 cases, 55 had VCI (incidence rate, 6.1%). After adjusting for potential confounders, blastocyst stage of development (adjusted odds ratio [aOR]: 4.3, 95% confidence interval [CI]: 1.9–12.7) and female sex (aOR: 2.2, 95% CI: 1.2–3.9) emerged as independent risk factors for the development of VCI. The fertilization method and type of embryo at the time of transfer did not affect the incidence of VCI. Conclusions Blastocyst stage of development and female sex pose a higher risk for developing VCI. Thus, more attention should be paid to pregnancies achieved by blastocyst and with a female fetus to detect VCI proactively and safeguard the health of both mother and fetus/neonate.