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Vafaei, H., Rafeei, K., Maryam Dalili, M. D., Asadi, N., Seirfar, N., & Akbarzadeh-Jahromi, M. (2021). Prevalence of single umbilical artery, clinical outcomes and its risk factors: A cross-sectional study. International Journal of Reproductive BioMedicine (IJRM), 19(5), 441–448. https://doi.org/10.18502/ijrm.v19i5.9253

https://doi.org/10.18502/ijrm.v19i5.9253

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  • Cited by 4 articles

authors

  • Homeira Vafaei

    Homeira Vafaei

    Maternal–Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Khatoon Rafeei

    Khatoon Rafeei

    Maternal–Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Maryam Dalili Maryam Dalili

    Maryam Dalili Maryam Dalili

    Clinical Research Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
  • Nasrin Asadi

    Nasrin Asadi

    Maternal–Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Nosaibe Seirfar

    Nosaibe Seirfar

    Pathology Department, Jiroft University of Medical Science, Jiroft, Iran
  • Mojgan Akbarzadeh-Jahromi

    Mojgan Akbarzadeh-Jahromi

    Maternal–Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
    https://orcid.org/0000-0003-0874-3127

Published Date

  • Jun 23, 2021

Prevalence of single umbilical artery, clinical outcomes and its risk factors: A cross-sectional study

International Journal of Reproductive BioMedicine (IJRM) / International Journal of Reproductive BioMedicine (IJRM): Volume 19, Issue No. 5 / Pages 441–448

Abstract

Background: Single umbilical artery (SUA) is found in 0.5–6% of all pregnancies worldwide. Although the association of SUA with some congenital malformations is mainly accepted, its effect on pregnancy/neonatal outcomes is still controversial.


Objective: This is the first study aimed to approximate the SUA prevalence in southern part of Iran. SUA epidemiologic features accompanied by some of its effects on pregnancy/neonatal outcomes are investigated as well.


Materials and Methods: In this cross-sectional study, data from two referral centers in Southern Iran were analyzed. In total, 1,469 pregnancies, fetuses, and neonates were examined for epidemiological features associated with SUA. SUA was confirmed by pathological examination, while congenital anomalies were diagnosed by clinical, ultrasound, and echocardiographical examinations. Data on pregnancy outcome were recorded based on the patients’ medical records.


Results: The prevalence of SUA was 3.47% (95% CI: 2.6–4.6%). Fetal anomalies including renal, cardiac, and other congenital anomalies, intrauterine fetal death, early neonatal death, low birth weight, low placental weight, and preterm birth were significantly higher in the SUA group (OR = 68.02, 31.04, 16.03, 3.85, 11.31, 3.22, 2.70, and 2.47, respectively). However, the maternal multiparity was lower in the SUA group (OR = 0.65; 95% CI: 0.44–0.98).


Conclusion: A significant association was observed between SUA and increased risk of intrauterine fetal death and early neonatal death, as well as low birth weight and preterm birth. Obstetrical history of the mother like parity was identified as an important predictor of SUA. Further investigations are suggested on risk stratification of neonates in this regard.  


Key words: Umbilical cord, Single umbilical artery, Pregnancy outcome, Congenital abnormalities.

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