Isolated single umbilical artery: evaluating the risk of adverse pregnancy outcome

Mailáth-Pokorny, Mariella; Worda, Katharina; Schmid, Maximilian; Polterauer, Stephan; Bettelheim, Dieter

doi:10.1016/j.ejogrb.2014.11.007

Cited by 33 publications

(30 citation statements)

References 20 publications

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“…Tulek et al [11] analyzed birth weight and found that SGA was three-fold as likely in pregnancies with iSUA compared to pregnancies with TVC. Other recent studies also reported similar results [1317181920]. However, Bombrys et al [14] found that iSUA was not associated with a higher rate of SGA in comparison with newborns with TVC (13.7% vs. 13.9%, P =0.93).…”

Section: Discussionsupporting

confidence: 60%

“…1. Table 1 shows the characteristics of the 11 included studies [1112131415161718192021]. The studies comprised 3 case-control studies and 8 cohort studies.…”

Section: Resultsmentioning

confidence: 99%

“…Significant heterogeneity was found (chi 2 =17.18, P =0.009, I 2 =65%) (Fig. 4) [11121317181920], so random-effect model was used. The association between PIH and iSUA were seen in all meta-analyses.…”

Section: Resultsmentioning

confidence: 99%

“…SUA is defined as an isolated SUA (iSUA), if it occurs with no congenital abnormality in fetal chromosomes or structure [11]; In approximately 65% to 80% of SUAs, it appears to be iSUAs. In pregnancies with an iSUA, variable outcomes of aneuploidy, small for gestational age (SGA), preterm birth, pregnancy-induced hypertension (PIH), neonatal intensive care unit (NICU) admission, and perinatal mortality have been reported when compared with those fetuses and neonates with three vessel cords (TVC) [1112131415161718192021]. However, a controversy exists concerning whether iSUA is associated with adverse perinatal outcomes, with other studies presenting different views.…”

Section: Introductionmentioning

confidence: 99%

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Association of isolated single umbilical artery with perinatal outcomes: Systemic review and meta-analysis

Kim

Chay

et al. 2017

Obstet Gynecol Sci

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ObjectiveThe aim of this study was to evaluate the association between prenatally diagnosed isolated single umbilical artery (iSUA) and perinatal outcomes.MethodsWe searched Medline, Embase, the Cochrane Library, and KoreaMed from inception to January 2016, with no language or regional restrictions, for cohort and case-control studies reporting on the relationship of iSUA and perinatal outcomes. We assessed the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission, and perinatal mortality in fetuses with iSUA compared with those in fetuses with three vessel cord.ResultsEleven articles totaling 1,731 pregnancies with iSUA met the selection criteria. Studies varied in design, quality, outcome definition, and results. Meta-analysis carried out within predefined groups showed that the presence of an iSUA was associated with small for gestational age (OR, 2.75; 95% CI, 1.97 to 3.83; P<0.00001), preterm birth (OR, 2.10; 95% CI, 1.72 to 2.57; P<0.00001), pregnancy-induced hypertension (OR, 1.62; 95% CI, 1.00 to 2.63; P=0.05), neonatal intensive care unit admission (OR, 2.06; 95% CI, 1.33 to 3.19; P=0.001), and perinatal mortality (OR, 2.29; 95% CI, 1.32 to 3.98; P=0.003).ConclusionPregnancies complicated by iSUA are at increased risk for small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission and perinatal mortality. Further, large prospective cohort studies are required to improve the quality of prenatal counseling and the neonatal care for pregnancies with iSUA.

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Section: Discussionsupporting

confidence: 60%

“…1. Table 1 shows the characteristics of the 11 included studies [1112131415161718192021]. The studies comprised 3 case-control studies and 8 cohort studies.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association of isolated single umbilical artery with perinatal outcomes: Systemic review and meta-analysis

Kim

Chay

et al. 2017

Obstet Gynecol Sci

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“…1,2,7,[8][9][10]13 A recent meta-analysis compiling data from four smaller case-control and three cohort studies did not find a significant association between SGA and an isolated single umbilical artery, whereas the largest retrospective study from Canada noted an association with birth weight less than the 10th and third percentiles as well as other adverse neonatal outcomes. 6,10 In our study, however, neonates with an isolated single umbilical artery weighed 284 g less at birth compared with the neonates in the control group.…”

Section: Discussionmentioning

confidence: 93%

Association of Isolated Single Umbilical Artery With Small for Gestational Age and Preterm Birth

Battarbee

Palatnik

Ernst

et al. 2015

Obstetrics &Amp; Gynecology

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Embryonic hypocellularity, blastogenetic malformations, and fetal growth restriction

Lubinsky

2016

American J of Med Genetics Pt A

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An association between congenital malformations and fetal growth restriction (FGR) can be largely explained by a relationship with early embryonic hypocellularity. The malformations include the VACTERL association, which is exceptional as a Mendelian syndrome, but is commonly associated with monozygotic twinning, maternal diabetes, and some forms of aneuploidy, all characterized by a small embryo early in development. Parsimony suggests that these different links to VACTERL are related to the hypocellularity as a single common factor, rather than as an expression of three independent pathogenetic processes. A distinct non-genetic pathogenesis is further supported by increased frequencies in the same conditions of a single umbilical artery (SUA), which is also unusual in Mendelian disorders. SUA often involves the atrophy of one artery, which may be facilitated by altered hemodynamics in a smaller embryo, providing a direct link to hypocellularity. Hypocellularity may also explain a possible connection between VACTERL and certain mitochondrial disorders, where reduced energy might slow early cell division and growth, reducing the size of the embryo. © 2016 Wiley Periodicals, Inc.

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Isolated single umbilical artery: evaluating the risk of adverse pregnancy outcome

Cited by 33 publications

References 20 publications

Association of isolated single umbilical artery with perinatal outcomes: Systemic review and meta-analysis

Association of isolated single umbilical artery with perinatal outcomes: Systemic review and meta-analysis

Association of Isolated Single Umbilical Artery With Small for Gestational Age and Preterm Birth

Embryonic hypocellularity, blastogenetic malformations, and fetal growth restriction

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