Early detection of velamentous cord insertion at the eighth week of gestation

Background Our hypothesis was that exposure to fine particulate matter (PM2.5) is related to abnormal cord insertion, which is categorized as a form of placental implantation abnormality. We investigated the association between exposure to total PM2.5 and its chemical components over the first trimester and abnormal cord insertion, which contributes to the occurrence of adverse birth outcomes. Methods From the Japan Perinatal Registry Network database, we used data on 83 708 women who delivered singleton births at 39 cooperating hospitals in 23 Tokyo wards (2013–2015). We collected PM2.5 on a filter and measured daily concentrations of carbon and ion components. Then, we calculated the average concentrations over the first trimester (0–13 weeks of gestation) for each woman. A multilevel logistic-regression model with the hospital as a random effect was used to estimate the odds ratios (ORs) of abnormal cord insertion. Results Among the 83 708 women (mean age at delivery = 33.7 years), the frequency of abnormal cord insertion was 4.5%, the median concentration [interquartile range (IQR)] of total PM2.5 was 16.1 (3.61) μg/m3 and the OR per IQR for total PM2.5 was 1.14 (95% confidence interval = 1.06–1.23). In the total PM2.5-adjusted models, total carbon, organic carbon, nitrate, ammonium and chloride were positively associated with abnormal insertion. Organic carbon was consistently, and nitrate tended to be, associated with specific types of abnormal insertion (marginal or velamentous cord insertion). Conclusions Exposure to total PM2.5 and some of its components over the first trimester increased the likelihood of abnormal cord insertion.

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Maternal exposure to fine particulate matter over the first trimester and umbilical cord insertion abnormalities

Michikawa

Morokuma

Takeda

et al. 2021

International Journal of Epidemiology

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Early detection of velamentous cord insertion at the eighth week of gestation

Abstract: Velamentous cord insertion can be diagnosed at 8 weeks of gestation, earlier than previously reported. Fetal surveillance may be informed and prognosis may be impacted by early diagnosis once viability is reached.

Cited by 1 publication

References 10 publications

Maternal exposure to fine particulate matter over the first trimester and umbilical cord insertion abnormalities

Maternal exposure to fine particulate matter over the first trimester and umbilical cord insertion abnormalities

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