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Isolated single umbilical artery poses neonates at increased risk of long-term respiratory morbidity
Ofer Beharier1, Eyal Sheiner2, Ruslan Sergienko3
1Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Beer-Sheva, 84101, Israel. oferbeharier@gmail.com.
Insights
Children born with isolated single umbilical artery (iSUA) face a higher risk of long-term respiratory issues. This study confirms iSUA as an independent risk factor for pediatric respiratory morbidity.
Area of Science:
- Pediatric Medicine
- Neonatology
- Obstetrics
Background:
- Isolated single umbilical artery (iSUA) is a common umbilical cord anomaly.
- The long-term respiratory health implications for infants born with iSUA are not fully understood.
Purpose of the Study:
- To investigate the association between isolated single umbilical artery (iSUA) at term and the risk of long-term pediatric hospitalizations due to respiratory morbidity.
- To determine if iSUA is an independent risk factor for respiratory health issues in children.
Main Methods:
- Population-based cohort study including singleton pregnancies from 1991-2013.
- Compared hospitalization rates for respiratory morbidity in children with and without iSUA.
- Utilized Kaplan-Meier survival curves and Cox proportional hazards models for analysis.
Main Results:
- The study included 232,281 deliveries, with 0.3% of newborns having iSUA.
- Newborns with iSUA exhibited a significantly higher rate of long-term respiratory morbidity (7.6% vs. 5.5%, p=0.01).
- iSUA was identified as an independent risk factor for long-term respiratory morbidity (adjusted HR=1.39, p=0.012) after controlling for confounders.
Conclusions:
- Newborns with isolated single umbilical artery (iSUA) are at an increased risk for long-term respiratory morbidity.
- iSUA is a significant predictor of future respiratory health problems in children.
Purpose:
To investigate whether children born with isolated single umbilical artery (iSUA) at term are at an increased risk for long-term pediatric hospitalizations due to respiratory morbidity.
Methods:
Design: a population-based cohort study compared the incidence of long-term, pediatric hospitalizations due to respiratory morbidity in children born with and without iSUA at term.
Setting:
Soroka University Medical Center.
Participants:
all singleton pregnancies of women who delivered between 1991 and 2013.
Main Outcome Measure(S):
hospitalization due to respiratory morbidity.
Analyses:
Kaplan-Meier survival curves were used to estimate cumulative incidence of respiratory morbidity. A Cox hazards model analysis was used to establish an independent association between iSUA and pediatric respiratory morbidity of the offspring while controlling for clinically relevant confounders.
Results:
The study included 232,281 deliveries. 0.3% were of newborns with iSUA (n = 766). Newborns with iSUA had a significantly higher rate of long-term respiratory morbidity compared to newborns without iSUA (7.6 vs 5.5%, p = 0.01). Using a Kaplan-Meier survival curve, newborns with iSUA had a significantly higher cumulative incidence of respiratory hospitalizations (log rank = 0.006). In the Cox model, while controlling for the maternal age, gestational age, and birthweight, iSUA at term was found to be an independent risk factor for long-term respiratory morbidity (adjusted HR = 1.39, 95% CI 1.08-1.81; p = 0.012).
Conclusion:
Newborns with iSUA are at an increased risk for long-term respiratory morbidity.
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