Association between isolated single umbilical artery and neurodevelopmental disorders: population-based study.

Area of Science:

• Perinatal Medicine
• Neurodevelopmental Pediatrics
• Medical Informatics

Background:

• Single umbilical artery (SUA) is linked to adverse perinatal outcomes and major anomalies.
• Limited data exists on the association between SUA and childhood neurodevelopmental disorders (NDD).
• Isolated SUA (iSUA) requires further investigation regarding NDD risk and mediating factors.

Purpose of the Study:

• To evaluate the risk of NDD in children with isolated SUA (iSUA).
• To assess the impact of sex on the iSUA-NDD association.
• To examine the mediating roles of gestational age and birth weight in the iSUA-NDD relationship.

Main Methods:

• Historical national cohort study linking Norwegian registries (1999-2013 births).
• Inclusion of singleton live births diagnosed with iSUA.
• Multilevel logistic regression and causal mediation analysis for NDD, preterm birth, and SGA.

Main Results:

• iSUA was associated with increased odds of intellectual disability (ID) and ADHD.
• Associations were observed in females but not males.
• Preterm birth and small-for-gestational age (SGA) mediated <10% of the iSUA-ID association.

Conclusions:

• iSUA shows a weak association with ID and ADHD, not other NDD.
• Sex influences the iSUA-NDD association.
• Findings are reassuring for counseling parents of fetuses with iSUA.