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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2018 ; 13
(3
): e0194814
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Extreme umbilical cord lengths, cord knot and entanglement: Risk factors and risk
of adverse outcomes, a population-based study
#MMPMID29584790
Linde LE
; Rasmussen S
; Kessler J
; Ebbing C
PLoS One
2018[]; 13
(3
): e0194814
PMID29584790
show ga
OBJECTIVES: To determine risk factors for short and long umbilical cord,
entanglement and knot. Explore their associated risks of adverse maternal and
perinatal outcome, including risk of recurrence in a subsequent pregnancy. To
provide population based gestational age and sex and parity specific reference
ranges for cord length. DESIGN: Population based registry study. SETTING: Medical
Birth Registry of Norway 1999-2013. POPULATION: All singleton births (gestational
age>22weeks<45 weeks) (n = 856 300). METHODS: Descriptive statistics and odds
ratios of risk factors for extreme cord length and adverse outcomes based on
logistic regression adjusted for confounders. MAIN OUTCOME MEASURES: Short or
long cord (<10th or >90th percentile), cord knot and entanglement, adverse
pregnancy outcomes including perinatal and intrauterine death. RESULTS:
Increasing parity, maternal height and body mass index, and diabetes were
associated with increased risk of a long cord. Large placental and birth weight,
and fetal male sex were factors for a long cord, which again was associated with
a doubled risk of intrauterine and perinatal death, and increased risk of adverse
neonatal outcome. Anomalous cord insertion, female sex, and a small placenta were
associated with a short cord, which was associated with increased risk of fetal
malformations, placental complications, caesarean delivery, non-cephalic
presentation, perinatal and intrauterine death. At term, cord knot was associated
with a quadrupled risk of perinatal death. The combination of a cord knot and
entanglement had a more than additive effect to the association to perinatal
death. There was a more than doubled risk of recurrence of a long or short cord,
knot and entanglement in a subsequent pregnancy of the same woman. CONCLUSION:
Cord length is influenced both by maternal and fetal factors, and there is
increased risk of recurrence. Extreme cord length, entanglement and cord knot are
associated with increased risk of adverse outcomes including perinatal death. We
provide population based reference ranges for umbilical cord length.