Cargando…
Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery
Objective: To investigate pregnancy outcomes of small for gestational age (SGA) neonates born with isolated single umbilical artery (iSUA) compared to SGA neonates without iSUA. Study Design: This was a population-based retrospective cohort analysis. The study group was defined as a singleton SGA ne...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433819/ https://www.ncbi.nlm.nih.gov/pubmed/30941337 http://dx.doi.org/10.3389/fped.2019.00079 |
_version_ | 1783406348389580800 |
---|---|
author | Blum, Maayan Weintraub, Adi Y. Baumfeld, Yael Rotem, Reut Pariente, Gali |
author_facet | Blum, Maayan Weintraub, Adi Y. Baumfeld, Yael Rotem, Reut Pariente, Gali |
author_sort | Blum, Maayan |
collection | PubMed |
description | Objective: To investigate pregnancy outcomes of small for gestational age (SGA) neonates born with isolated single umbilical artery (iSUA) compared to SGA neonates without iSUA. Study Design: This was a population-based retrospective cohort analysis. The study group was defined as a singleton SGA neonate born with iSUA, while an SGA neonate without iSUA comprised the comparison group. We evaluated adverse perinatal outcomes in all SGA neonates born at the Soroka University Medical Center between the years 1998–2013. Multiple gestations, fetuses with known congenital malformations or chromosomal abnormalities and patients with lack of prenatal care were excluded from the study. Multivariate logistic regression models were constructed to identify independent factors associated with adverse perinatal outcomes. Results: Of 12,915 SGA deliveries, 1.2% (162) were complicated with iSUA. Women in the study group were older with a significantly lower gestational age at delivery compared with the comparison group. Rates of women who conceived after infertility treatments were higher in the study group. Additionally, patients in the study group had significantly higher rates of preterm deliveries, placental abruption, cord prolapse, non-reassuring fetal heart rates and cesarean delivery were noted in the study group. These neonates had a significantly lower birth weight (1988.0 ± 697 vs. 2388.3 ± 481 p < 0.001) and higher rates of low APGAR scores at the first and fifth minutes after birth compared with controls. Perinatal mortality was also found to be significantly higher among SGA neonates complicated with iSUA. Preterm delivery as well as perinatal mortality were found independently associated with iSUA among SGA neonates (aOR 4.01, 95% CI 2.88–5.59, aOR 2.24, 95% CI 1.25–4.01, respectively). Conclusion: SGA pregnancies complicated with iSUA are at higher risk for adverse pregnancy and perinatal outcomes as compared to SGA pregnancies without iSUA. |
format | Online Article Text |
id | pubmed-6433819 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-64338192019-04-02 Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery Blum, Maayan Weintraub, Adi Y. Baumfeld, Yael Rotem, Reut Pariente, Gali Front Pediatr Pediatrics Objective: To investigate pregnancy outcomes of small for gestational age (SGA) neonates born with isolated single umbilical artery (iSUA) compared to SGA neonates without iSUA. Study Design: This was a population-based retrospective cohort analysis. The study group was defined as a singleton SGA neonate born with iSUA, while an SGA neonate without iSUA comprised the comparison group. We evaluated adverse perinatal outcomes in all SGA neonates born at the Soroka University Medical Center between the years 1998–2013. Multiple gestations, fetuses with known congenital malformations or chromosomal abnormalities and patients with lack of prenatal care were excluded from the study. Multivariate logistic regression models were constructed to identify independent factors associated with adverse perinatal outcomes. Results: Of 12,915 SGA deliveries, 1.2% (162) were complicated with iSUA. Women in the study group were older with a significantly lower gestational age at delivery compared with the comparison group. Rates of women who conceived after infertility treatments were higher in the study group. Additionally, patients in the study group had significantly higher rates of preterm deliveries, placental abruption, cord prolapse, non-reassuring fetal heart rates and cesarean delivery were noted in the study group. These neonates had a significantly lower birth weight (1988.0 ± 697 vs. 2388.3 ± 481 p < 0.001) and higher rates of low APGAR scores at the first and fifth minutes after birth compared with controls. Perinatal mortality was also found to be significantly higher among SGA neonates complicated with iSUA. Preterm delivery as well as perinatal mortality were found independently associated with iSUA among SGA neonates (aOR 4.01, 95% CI 2.88–5.59, aOR 2.24, 95% CI 1.25–4.01, respectively). Conclusion: SGA pregnancies complicated with iSUA are at higher risk for adverse pregnancy and perinatal outcomes as compared to SGA pregnancies without iSUA. Frontiers Media S.A. 2019-03-19 /pmc/articles/PMC6433819/ /pubmed/30941337 http://dx.doi.org/10.3389/fped.2019.00079 Text en Copyright © 2019 Blum, Weintraub, Baumfeld, Rotem and Pariente. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Blum, Maayan Weintraub, Adi Y. Baumfeld, Yael Rotem, Reut Pariente, Gali Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery |
title | Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery |
title_full | Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery |
title_fullStr | Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery |
title_full_unstemmed | Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery |
title_short | Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery |
title_sort | perinatal outcomes of small for gestational age neonates born with an isolated single umbilical artery |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433819/ https://www.ncbi.nlm.nih.gov/pubmed/30941337 http://dx.doi.org/10.3389/fped.2019.00079 |
work_keys_str_mv | AT blummaayan perinataloutcomesofsmallforgestationalageneonatesbornwithanisolatedsingleumbilicalartery AT weintraubadiy perinataloutcomesofsmallforgestationalageneonatesbornwithanisolatedsingleumbilicalartery AT baumfeldyael perinataloutcomesofsmallforgestationalageneonatesbornwithanisolatedsingleumbilicalartery AT rotemreut perinataloutcomesofsmallforgestationalageneonatesbornwithanisolatedsingleumbilicalartery AT parientegali perinataloutcomesofsmallforgestationalageneonatesbornwithanisolatedsingleumbilicalartery |