Battarbee Ashley N, Palatnik Anna, Ernst Linda M, Grobman William A
Departments of Obstetrics and Gynecology and Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Obstet Gynecol. 2015 Oct;126(4):760-764. doi: 10.1097/AOG.0000000000001037.
To assess the association of an isolated single umbilical artery with small for gestational age (SGA) and preterm birth.
In this retrospective cohort study, 219 consecutive women carrying a fetus with an isolated single umbilical artery diagnosed during routine second-trimester anatomic survey were compared with 219 women carrying a fetus with a three-vessel cord. Pregnancies with fetal anomalies or aneuploidy were excluded from the analysis. Outcomes included pregnancy-induced hypertension, gestational age at birth, birth weight, SGA, defined as birth weight less than the 10th percentile, and indicated or spontaneous preterm birth, defined as delivery before 37 weeks of gestation.
In univariable analysis, the presence of an isolated single umbilical artery was significantly associated with lower birth weight (3,146 compared with 3,430 g) and with SGA (11.9% compared with 2.7%; P<.001 for each outcome). The rates of pregnancy-induced hypertension (7.3% compared with 1.8%, P=.01) and indicated but not spontaneous preterm delivery (5.5% compared with 0.9%, P=.01 for indicated and 8.2% compared with 4.6%, P=.12 for spontaneous) were also more common in pregnancies with an isolated single umbilical artery. In multivariable analysis controlling for potential confounders, an isolated single umbilical artery remained associated with SGA, pregnancy-induced hypertension, and medically indicated preterm birth (adjusted odds ratio [OR] 3.97, confidence interval [CI] 1.55-10.12; adjusted OR 3.50, CI 1.10-11.18; adjusted OR 7.35, CI 1.60-33.77, respectively).
Pregnancies complicated by isolated single umbilical artery are at increased risk for SGA and pregnancy-induced hypertension but not for spontaneous preterm birth.
II.
评估孤立性单脐动脉与小于胎龄儿（SGA）及早产之间的关联。
在这项回顾性队列研究中，将219例在孕中期常规解剖检查时诊断为孤立性单脐动脉胎儿的连续孕妇，与219例三血管脐带胎儿的孕妇进行比较。分析中排除了合并胎儿畸形或非整倍体的妊娠。结局包括妊娠期高血压、出生孕周、出生体重、SGA（定义为出生体重低于第10百分位数）以及指征性或自发性早产（定义为妊娠37周前分娩）。
在单变量分析中，孤立性单脐动脉的存在与较低的出生体重（3146克与3430克相比）以及SGA显著相关（11.9%与2.7%相比；每项结局P<0.001）。孤立性单脐动脉妊娠中妊娠期高血压的发生率（7.3%与1.8%相比，P=0.01）以及指征性而非自发性早产的发生率（指征性5.5%与0.9%相比，P=0.01；自发性8.2%与4.6%相比，P=0.12）也更为常见。在控制潜在混杂因素的多变量分析中，孤立性单脐动脉仍与SGA、妊娠期高血压以及医学指征性早产相关（调整后的优势比[OR]分别为3.97，置信区间[CI]1.55 - 10.12；调整后的OR 3.50，CI 1.10 - 11.18；调整后的OR 7.35，CI 1.60 - 33.77）。
合并孤立性单脐动脉的妊娠发生SGA和妊娠期高血压的风险增加，但自发性早产风险未增加。
II级
