Long-term physical and neurologic development in newborn infants with isolated single umbilical artery

Abstract

OBJECTIVE This study compared birth parameters and the longitudinal course in physical and neurologic development between children with 2 and 3 vessel umbilical cords. STUDY DESIGN Our study of the Collaborative Perinatal Project included singletons of at least 24 weeks’ gestation with single umbilical artery at birth and no identifiable congenital anomalies. Demographics that were collected included maternal age, race, smoking status, and socioeconomic index. Delivery data included gestational age, birth-weight, Apgar scores, placental weight, and umbilical cord insertion and length. Growth and neurodevelopmental parameters were collected at various intervals from birth to 7 years. RESULTS There were 263 infants with isolated single umbilical artery and 41,415 infants with 3 vessel cords. A random effect model that controlled for potential confounders did not show clinically significant differences in the physical and neurodevelopment measures between these groups. CONCLUSION Our study shows no evidence of differential longitudinal physical growth or neurologic outcomes between infants with 2 or 3 vessel cords.

Is echocardiography necessary for all single umbilical artery fetuses? A retrospective study in a selected Chinese population

“…During prenatal fetal abnormality screening, it is recognized as a soft marker of congenital structural malformation, chromosomal defect, fetal growth restriction, premature and low birthweight . Extremely high risk of structural abnormality in all major organ systems, including abnormality in genitourinary, musculoskeletal, gastrointestinal, cardiovascular and central nervous systems, was detected in SUA fetus, which was higher than those with double umbilical artery …”

Should fetal growth be a matter of concern in isolated single umbilical artery?

“…Compensatory mechanisms allow increase in blood flow through the single artery in order to meet the demands of fetal growth and development throughout pregnancy. 3 Although several studies have reported diminished fetal growth in these pregnancies, [4][5][6][7][8][9][10][11][12] others have not shown differences. [13][14][15] These contradictory findings may be attributed to diverse methodological differences in the published literature.…”

“…Additional clinical relevance of ISUA was also evaluated after birth in a prospective cohort by Chetty-John et al 10 No significant differences in physical growth and neurological development were observed. There was also no evidence of increased need for admission to neonatal intensive care units (Bombrys et al).…”

“…6,7,11,[13][14][15]18,[20][21][22][23] On the other hand, all post-natal studies have shown that birth weight is significantly lower in ISUA pregnancies compared to control pregnancies. 5,9,10,12 This is possibly related to the fact that these are the studies with greater sample size. Moreover, since ISUA was not diagnosed …”

Impact of isolated single umbilical artery on pregnancy outcome and delivery in full‐term births

“…As is well known, umbilical cords are an important channel for fetuses and mothers to exchange oxygen, nutrients and waste materials. Some scholars believe that an SUA might cause atrophy and extensive fibrin accumulation in certain areas of the placenta, chorionic villus edema or reduced blood flow in the fetal circulation, which will induce secondary hypoxia, hypogenesis and other conditions, such as fetal growth restriction . Other scholars believe that there is no significant difference in neonatal outcome when the SUA is found without other anomalies .…”