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Published on: February 5, 2021
Congenital oral mucosal abnormalities in true umbilical cord knots
Claudio De Felice1, Giorgio Bianciardi, Stefano Parrini
1Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Insights
Newborns with true umbilical cord knots exhibit significant congenital oral mucosal changes, including mandibular frenulum agenesis and altered oral vascular networks. This suggests a link to subclinical extracellular matrix disorders.
Area of Science:
- Perinatology
- Developmental Biology
- Oral Medicine
Background:
- True umbilical cord knots are associated with debated pathogenesis and clinical significance.
- Congenital oral mucosal changes in newborns with true umbilical cord knots require further investigation.
Purpose of the Study:
- To test the hypothesis that newborns with true umbilical cord knots have congenital oral mucosal changes.
- To investigate the association between true umbilical cord knots and oral frenulum abnormalities and vascular network geometry.
Main Methods:
- Compared 7 infants with true umbilical cord knots to 50 matched controls.
- Analyzed oral frenulum abnormalities and two-dimensional vascular network geometry (fractal dimension and Lempel-Ziv complexity).
Main Results:
- Infants with true umbilical cord knots had significantly higher rates of mandibular frenulum agenesis (p = 0.000006).
- Oral vascular networks in these infants showed significantly higher fractal dimensions (D(1-46), D(1-15)) and Lempel-Ziv complexity (p < 0.0001).
Conclusions:
- True umbilical cord knots are associated with significant congenital oral mucosal changes.
- Findings suggest a potential link between true umbilical cord knots and subclinical extracellular matrix disorders.
Objective:
The pathogenesis and clinical significance of true umbilical cord knots remain controversial. Here, we tested the hypothesis of the presence of congenital oral mucosal changes in newborns with true umbilical cord knots.
Study Design:
Seven consecutive infants with true umbilical cord knots and 50 gestational age- and sex-matched controls were enrolled. The proportion of oral frenulum abnormalities and the two-dimensional vascular network geometry [fractal dimension, D, at two scales: D(1-46), and D(1-15), with the relative Lempel-Ziv complexity, (L-Z)], were analyzed.
Results:
Infants with true umbilical cord knots showed significantly higher proportions of mandibular frenulum agenesis compared to controls (p = 0.000006). The oral vascular networks of these infants exhibited a significantly higher D(1-46) and D(1-15) (p < 0.0001, respectively), and higher L-Z values (p < 0.0001) than control networks.
Conclusion:
These findings indicate the presence of significant congenital oral mucosal changes in newborn infants with true umbilical cord knots, thus suggesting a previously unrecognized association between true umbilical cord knots and a subclinical extracellular matrix disorder.
