Approximately 6 percent of infants ...

Approximately 6 percent of infants are delivered with a short umbilical cord. This condition has been associated with several abnormalities during pregnancy and complications of labor and delivery, yet little is known about the etiology of short cord or its associated complications. Krakowiak and colleagues used a population-based, case-control investigation in one state of more than 17000 singleton live births through 11 years to identify risk factors and adverse consequences associated with a short umbilical cord.

They used a statewide database that linked information from birth certificates, hospital maternal and infant records, and infant deaths. The 3565 infants diagnosed with short cords by dint of any record of an appropriate International Classification of Diseases, 9th rev (ICD-9) digest were compared with 14,260 randomly prefered control infants born in the same year. The variables of interest were possible causes or inferences of a short cord identified by dint of previous studies. The latter included maternal carcass mass index (BMI), smoking, alcohol use, parity, previous poor results of pregnancy, and several fetal characteristics.

During the contemplation more than 900,000 live singleton births were recorded, giving an incidence of four for 1,000 live infants born with a short umbilical cord. The mothers of the short-cord infants were likely to have more formal education and les likely to use Medicaid insurance than the dominion government group, but these and other differences between the pair groups were not statistically significant. The greatest differences between the subject of attention and control groups as assessed by the agency of the odds ratios (ORs) were in an exces of fetal malformation (OR, 16) oligohydramnios or polyhydramnios (14) first pregnancy (14) and female infant (13); and a relatively lower incidence of high BMI (07) hypertension (07) parity three or more (07) early amniocentesis (07) gestational diabetes (07) and eclampsia (03) Within the congenital malformations classification, infants with short cords had double the risk of chromosomal, gastrointestinal, and circulatory or respiratory malformations. Mothers of infants with short cords had increased risk of retained placenta, operative vaginal delivery, extended labor, and other complications of delivery. The short-cord infants had increased risk of being small for gestational age and having fetal distress. Overall, the relative risk of death within individual year in infants born with a short umbilical cord was 24

The authors decide that the incidence of short cord was stable at about four through 1,000 live births each year. No modifiable risk factors for the condition were identified, on the other hand it was associated with certain congenital abnormalities. They commend that infants born with short cords be monitored closely because of the observ high mortality during the first year of life.

Krakowiak P et al. Risk factors and results associated with a short umbilical cord. Obstet Gynecol January 2004;103:119-27

COPYRIGHT 2004 American Academy of Family Physicians

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