Silva Gabriel Viana, Gontijo Carolina Toledo, Lunguinho Ana Paola Cruz, Caetano Mário Sérgio Gomes, Callado Gustavo Yano, Araujo Júnior Edward, Peixoto Alberto Borges
Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba 38025-440, MG, Brazil.
Albert Einstein Israelite College of Health Sciences, Albert Einstein Israelite Hospital, São Paulo 05653-120, SP, Brazil.
Diagnostics (Basel). 2025 May 9;15(10):1197. doi: 10.3390/diagnostics15101197.
: To evaluate and compare whether the presence of a nuchal cord (NC) and its characteristics had a negative impact on perinatal outcomes during delivery. : This was a retrospective cohort study that analyzed the medical records of pregnant women from March 2020 to June 2023. Pregnant women were divided into groups with and without an NC. Singleton pregnancies ≥ 37 weeks were included, excluding fetal malformations, chromosomal anomalies, and cases with missing data and cord blood gas. : Of the 3364 medical records analyzed, 466 were included-366 without and 100 with an NC. Among the cases with an NC, 91% had one loop and 9% had ≥ two loops; 82% were loose and 18% were tight. Pregnant women with an NC had a higher gestational age (39.7 vs. 39.1 weeks, = 0.006), fewer deliveries (1.0 vs. 2.0, = 0.035), and a higher prevalence of cesarean sections (99% vs. 60.4%, < 0.001). An NC was associated with a lower Apgar score at the 1st minute (8 vs. 9, = 0.014) and higher arterial cord blood pH (7.27 vs. 7.24, = 0.020). The presence of a tight cord was significantly associated with a 7.52-fold increased risk of an Apgar score < 7 at the 1st minute [x(1) = 5.92, OR: 7.52, 95% CI: 1.51-37.31, R Nagelkerke: 0.14, = 0.014]. : There was no effect of the presence of an NC on adverse perinatal outcomes. However, the presence of a tight NC was associated with an increased risk of an Apgar score < 7 at the 1st minute, but no other effect on neonatal outcomes.
评估并比较脐带绕颈（NC）的存在及其特征是否会对分娩期间的围产期结局产生负面影响。
这是一项回顾性队列研究，分析了2020年3月至2023年6月孕妇的病历。孕妇被分为有和没有脐带绕颈的组。纳入单胎妊娠≥37周的孕妇，排除胎儿畸形、染色体异常以及数据缺失和脐血气异常的病例。
在分析的3364份病历中，466份被纳入——366份没有脐带绕颈，100份有脐带绕颈。在有脐带绕颈的病例中，91%有一圈，9%有两圈及以上；82%为松弛型，18%为紧束型。有脐带绕颈的孕妇孕周更高（39.7周对39.1周，P = 0.006），分娩次数更少（1.0次对2.0次，P = 0.035），剖宫产率更高（99%对60.4%，P < 0.001）。脐带绕颈与出生后1分钟时较低的阿氏评分（8分对9分，P = 0.014）和较高的脐动脉血pH值（7.27对7.24，P = 0.020）相关。紧束型脐带的存在与出生后1分钟时阿氏评分<7分的风险显著增加7.52倍相关[x(1)=5.92，OR：7.52，95%CI：1.51 - 37.31，Nagelkerke R：0.14，P = 0.014]。
脐带绕颈的存在对不良围产期结局没有影响。然而，紧束型脐带绕颈的存在与出生后1分钟时阿氏评分<7分的风险增加相关，但对新生儿结局没有其他影响。
