TY - JOUR
T1 - Abnormal Placental Cord Insertion and Adverse Pregnancy Outcomes
T2 - Results from a Prospective Cohort Study
AU - Ismail, Khadijah I.
AU - Hannigan, Ailish
AU - Kelehan, Peter
AU - O'Donoghue, Keelin
AU - Cotter, Amanda
N1 - Publisher Copyright:
© 2017 by Thieme Medical Publishers, Inc.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Objectives To prospectively measure the distance from the placental cord insertion (PCI) site to the placental margin using digital imaging and to examine the association between abnormal PCI and adverse pregnancy outcomes in singleton pregnancies. Study Design This prospective cohort study examined 1,005 placentas from consecutively delivered singleton pregnancies in a tertiary center. Standardized images of each placenta were taken and digital measurement was performed using ImageJ software. Results The rates of velamentous (insertion into the membrane) and marginal (<2 cm from placental margin) cord insertions in a total of 1,005 singleton pregnancies were 3.6% (n = 36; 95% confidence interval [CI] = 2.5-4.9%) and 6.4% (n = 64; 95% CI = 4.9-8.1%), respectively. Abnormal PCI was found to be more common among smokers compared with non-smokers (22.7 vs. 14.8%, p = 0.04). Abnormal PCI was found to be significantly associated with small for gestational age (adjusted odds ratio [OR]: 1.73; 95% CI: 1.01-2.97, p = 0.047) and low birth weight (adjusted OR: 3.87; 95% CI: 1.72-8.71, p = 0.001). Conclusion Digital imaging analysis using ImageJ software mapped the surface of the placenta and provided objective measurement of PCI site. In this large prospective cohort, abnormal PCIs were significantly associated with an increased risk of small for gestational age and low birth weight.
AB - Objectives To prospectively measure the distance from the placental cord insertion (PCI) site to the placental margin using digital imaging and to examine the association between abnormal PCI and adverse pregnancy outcomes in singleton pregnancies. Study Design This prospective cohort study examined 1,005 placentas from consecutively delivered singleton pregnancies in a tertiary center. Standardized images of each placenta were taken and digital measurement was performed using ImageJ software. Results The rates of velamentous (insertion into the membrane) and marginal (<2 cm from placental margin) cord insertions in a total of 1,005 singleton pregnancies were 3.6% (n = 36; 95% confidence interval [CI] = 2.5-4.9%) and 6.4% (n = 64; 95% CI = 4.9-8.1%), respectively. Abnormal PCI was found to be more common among smokers compared with non-smokers (22.7 vs. 14.8%, p = 0.04). Abnormal PCI was found to be significantly associated with small for gestational age (adjusted odds ratio [OR]: 1.73; 95% CI: 1.01-2.97, p = 0.047) and low birth weight (adjusted OR: 3.87; 95% CI: 1.72-8.71, p = 0.001). Conclusion Digital imaging analysis using ImageJ software mapped the surface of the placenta and provided objective measurement of PCI site. In this large prospective cohort, abnormal PCIs were significantly associated with an increased risk of small for gestational age and low birth weight.
KW - abnormal cord insertion
KW - digital measurements
KW - low birth weight
KW - marginal cord insertion
KW - objective measurements
KW - placental cord insertion
KW - singletons
KW - small for gestational age
KW - velamentous cord insertion
UR - http://www.scopus.com/inward/record.url?scp=85026554328&partnerID=8YFLogxK
U2 - 10.1055/s-0037-1604413
DO - 10.1055/s-0037-1604413
M3 - Article
C2 - 28738435
AN - SCOPUS:85026554328
SN - 0735-1631
VL - 34
SP - 1152
EP - 1159
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 11
ER -