caa a22 4500 445308974 CHVBK 20180317142622.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s00404-009-1326-3 doi (NATIONALLICENCE)springer-10.1007/s00404-009-1326-3 Is single umbilical artery an independent risk factor for perinatal mortality? [Elektronische Daten] [Shimon Burshtein, Amalia Levy, Gershon Holcberg, Alexander Zlotnik, Eyal Sheiner] Objective: To evaluate perinatal outcome of fetuses with isolated single umbilical artery (SUA), and specifically to examine whether an isolated SUA is an independent risk factor for perinatal mortality. Methods: A population-based study was conducted, comparing pregnancies of women with and without SUA. Deliveries occurred between the years 1988-2006, in a tertiary medical center. Multiple gestations, chromosomal abnormalities and malformations were excluded from the analysis. Stratified analysis was performed using multiple logistic regression models to evaluate the association between SUA and perinatal mortality, while controlling for confounders. Results: Out of 194,809 deliveries, 243 (0.1%) were of fetuses with isolated SUA. Fetuses with SUA were smaller (2,844±733 vs. 3,197±530g, P<0.001), and were delivered at an earlier gestational age (38.3±3.0 vs. 39.3±2.1weeks, P<0.001), when compared with fetuses with normal umbilical vessels. Mothers to fetuses with isolated SUA tended to have a history of infertility treatments (4.5 vs. 1.7%; P=0.001) when compared with the comparison group. Fetuses with SUA had more complications, including fetal growth restriction (FGR 9.5 vs. 1.9%, P<0.001), polyhydramnios (11.5 vs. 3.7%; P<0.001) and oligohydramnios (6.6 vs. 2.2%; P<0.001). Deliveries of SUA fetuses had higher rates of placental abruption (3.3 vs. 0.7%; P<0.001), placenta previa (1.2 vs. 0.4%; P=0.03) and cord prolapse (2.9 vs. 0.4%; P<0.001). Higher rates of cesarean deliveries were noted in this group (23.9 vs. 12.2%; P<0.001). SUA newborns had higher rates of low Apgar scores (<7) in one (11.8 vs. 3.7%; P<0.001) and 5min (3.5 vs. 0.4%; P<0.001). Higher rates of perinatal mortality were noted in the SUA group, as compared to fetuses with normal umbilical vessels (6.6 vs. 0.9%, OR 7.78; 95% CI 4.7-13.0; P<0.001). Using a multiple logistic regression model, controlling for possible confounders, such as FGR, oligohydramnios, polyhydramnios, prolapse of cord, maternal hypertension and diabetes mellitus, isolated SUA remained an independent risk factor for perinatal mortality (adjusted OR=3.91, 95% CI 2.06-7.43; P<0.001). Conclusion: Isolated SUA in our population was noted as an independent risk factor for perinatal mortality. Springer-Verlag, 2009 Single umbilical artery nationallicence Preterm delivery nationallicence FGR nationallicence Low birth weight nationallicence Pregnancy outcome nationallicence Burshtein Shimon Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel aut Levy Amalia Department of Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel aut Holcberg Gershon Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel aut Zlotnik Alexander Department of Anesthesiology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel aut Sheiner Eyal Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel aut Archives of Gynecology and Obstetrics Springer-Verlag 283/2(2011-02-01), 191-194 0932-0067 283:2<191 2011 283 404 https://doi.org/10.1007/s00404-009-1326-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-009-1326-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Burshtein Shimon Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel aut NATIONALLICENCE 700 1- Levy Amalia Department of Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel aut NATIONALLICENCE 700 1- Holcberg Gershon Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel aut NATIONALLICENCE 700 1- Zlotnik Alexander Department of Anesthesiology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel aut NATIONALLICENCE 700 1- Sheiner Eyal Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 283/2(2011-02-01), 191-194 0932-0067 283:2<191 2011 283 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer