Vafaei Homeira, Rafeei Khatoon, Dalili Maryam, Asadi Nasrin, Seirfar Nosaibe, Akbarzadeh-Jahromi Mojgan
Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Obstetrics and Gynecology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Int J Reprod Biomed. 2021 Jun 23;19(5):441-448. doi: 10.18502/ijrm.v19i5.9253. eCollection 2021 May.
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.
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.
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.
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).
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.
单脐动脉（SUA）在全球所有妊娠中的发生率为0.5%至6%。尽管SUA与一些先天性畸形的关联已被广泛认可，但其对妊娠/新生儿结局的影响仍存在争议。
这是第一项旨在估算伊朗南部SUA患病率的研究。同时，还研究了SUA的流行病学特征及其对妊娠/新生儿结局的一些影响。
在这项横断面研究中，分析了伊朗南部两个转诊中心的数据。总共对1469例妊娠、胎儿和新生儿进行了与SUA相关的流行病学特征检查。通过病理检查确诊SUA，而先天性异常则通过临床、超声和超声心动图检查进行诊断。根据患者的病历记录妊娠结局数据。
SUA的患病率为3.47%（95%置信区间：2.6 - 4.6%）。SUA组胎儿异常（包括肾脏、心脏和其他先天性异常）、宫内胎儿死亡、早期新生儿死亡、低出生体重、低胎盘重量和早产的发生率显著更高（OR分别为68.02、31.04、16.03、3.85、11.31、3.22、2.70和2.47）。然而，SUA组的母亲多胎妊娠率较低（OR = 0.65；95%置信区间：0.44 - 0.98）。
观察到SUA与宫内胎儿死亡、早期新生儿死亡风险增加以及低出生体重和早产之间存在显著关联。母亲的产科病史如产次被确定为SUA的重要预测因素。建议在这方面对新生儿进行进一步的风险分层研究。
