Yoshihara Tatsuya, Okuda Yasuhiko, Owada So, Ono Yosuke, Sasatsu Satoko, Ogi Maki, Ogasahara Eriko, Yoshino Osamu
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
Placenta. 2025 Apr;163:29-32. doi: 10.1016/j.placenta.2025.02.017. Epub 2025 Feb 27.
Marginal cord insertion (MCI) is often defined as an abnormal placental cord insertion (PCI), yet there is limited discussion on the maternal backgrounds and perinatal complications associated with its occurrence. This retrospective cohort study aimed to investigate maternal backgrounds associated with MCI and to compare perinatal outcomes between MCI and normal PCI.
The study included 1038 deliveries from 2021 to 2023 in our institution, examining maternal backgrounds and perinatal outcomes. Multivariable logistic regression analysis was conducted for variables that showed significance in univariate analysis of maternal backgrounds. For perinatal outcomes, variables that exhibited significance were further analyzed using multivariable logistic regression, considering factors previously reported to be associated with those events.
9.5 % exhibited MCI. Assisted reproductive technology, nulliparous, and congenital uterine anomalies were identified as independent risk factors for MCI. In perinatal outcomes, fetal growth restriction (FGR) and emergency cesarean section were significantly more prevalent in cases with MCI. Even when compared to factors previously reported to be associated with FGR and emergency cesarean section, MCI remained an independent risk factor.
In addition to previously reported factors such as ART and primiparity, uterine anomalies were also identified as risk factors for MCI. It is important to manage MCI with the awareness that it increases the incidence of perinatal complications.
