Association of isolated single umbilical artery with perinatal outcomes: Systemic review and meta-analysis

Hyeong Ju Kim, Jae-Hoon Kim, Doo Byung Chay, Joo Hyun Park, Min A. Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective The aim of this study was to evaluate the association between prenatally diagnosed isolated single umbilical artery (iSUA) and perinatal outcomes. Methods We searched Medline, Embase, the Cochrane Library, and KoreaMed from inception to January 2016, with no language or regional restrictions, for cohort and case-control studies reporting on the relationship of iSUA and perinatal outcomes. We assessed the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission, and perinatal mortality in fetuses with iSUA compared with those in fetuses with three vessel cord. Results Eleven articles totaling 1,731 pregnancies with iSUA met the selection criteria. Studies varied in design, quality, outcome definition, and results. Meta-analysis carried out within predefined groups showed that the presence of an iSUA was associated with small for gestational age (OR, 2.75; 95% CI, 1.97 to 3.83; P < 0.00001), preterm birth (OR, 2.10; 95% CI, 1.72 to 2.57; P < 0.00001), pregnancy-induced hypertension (OR, 1.62; 95% CI, 1.00 to 2.63; P=0.05), neonatal intensive care unit admission (OR, 2.06; 95% CI, 1.33 to 3.19; P = 0.001), and perinatal mortality (OR, 2.29; 95% CI, 1.32 to 3.98; P=0.003). Conclusion Pregnancies complicated by iSUA are at increased risk for small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission and perinatal mortality. Further, large prospective cohort studies are required to improve the quality of prenatal counseling and the neonatal care for pregnancies with iSUA.

Original languageEnglish
Pages (from-to)266-273
Number of pages8
JournalObstetrics and Gynecology Science
Volume60
Issue number3
DOIs
Publication statusPublished - 2017 May 1

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Single Umbilical Artery
Meta-Analysis
Odds Ratio
Confidence Intervals
Pregnancy Induced Hypertension
Perinatal Mortality
Neonatal Intensive Care Units
Premature Birth
Gestational Age
Pregnancy
Fetus
Patient Selection
Libraries
Case-Control Studies
Counseling
Cohort Studies
Language
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

Cite this

Kim, Hyeong Ju ; Kim, Jae-Hoon ; Chay, Doo Byung ; Park, Joo Hyun ; Kim, Min A. / Association of isolated single umbilical artery with perinatal outcomes : Systemic review and meta-analysis. In: Obstetrics and Gynecology Science. 2017 ; Vol. 60, No. 3. pp. 266-273.
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abstract = "Objective The aim of this study was to evaluate the association between prenatally diagnosed isolated single umbilical artery (iSUA) and perinatal outcomes. Methods We searched Medline, Embase, the Cochrane Library, and KoreaMed from inception to January 2016, with no language or regional restrictions, for cohort and case-control studies reporting on the relationship of iSUA and perinatal outcomes. We assessed the odds ratios (ORs) and 95{\%} confidence intervals (CIs) for the occurrence of small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission, and perinatal mortality in fetuses with iSUA compared with those in fetuses with three vessel cord. Results Eleven articles totaling 1,731 pregnancies with iSUA met the selection criteria. Studies varied in design, quality, outcome definition, and results. Meta-analysis carried out within predefined groups showed that the presence of an iSUA was associated with small for gestational age (OR, 2.75; 95{\%} CI, 1.97 to 3.83; P < 0.00001), preterm birth (OR, 2.10; 95{\%} CI, 1.72 to 2.57; P < 0.00001), pregnancy-induced hypertension (OR, 1.62; 95{\%} CI, 1.00 to 2.63; P=0.05), neonatal intensive care unit admission (OR, 2.06; 95{\%} CI, 1.33 to 3.19; P = 0.001), and perinatal mortality (OR, 2.29; 95{\%} CI, 1.32 to 3.98; P=0.003). Conclusion Pregnancies complicated by iSUA are at increased risk for small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission and perinatal mortality. Further, large prospective cohort studies are required to improve the quality of prenatal counseling and the neonatal care for pregnancies with iSUA.",
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Association of isolated single umbilical artery with perinatal outcomes : Systemic review and meta-analysis. / Kim, Hyeong Ju; Kim, Jae-Hoon; Chay, Doo Byung; Park, Joo Hyun; Kim, Min A.

In: Obstetrics and Gynecology Science, Vol. 60, No. 3, 01.05.2017, p. 266-273.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of isolated single umbilical artery with perinatal outcomes

T2 - Systemic review and meta-analysis

AU - Kim, Hyeong Ju

AU - Kim, Jae-Hoon

AU - Chay, Doo Byung

AU - Park, Joo Hyun

AU - Kim, Min A.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Objective The aim of this study was to evaluate the association between prenatally diagnosed isolated single umbilical artery (iSUA) and perinatal outcomes. Methods We searched Medline, Embase, the Cochrane Library, and KoreaMed from inception to January 2016, with no language or regional restrictions, for cohort and case-control studies reporting on the relationship of iSUA and perinatal outcomes. We assessed the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission, and perinatal mortality in fetuses with iSUA compared with those in fetuses with three vessel cord. Results Eleven articles totaling 1,731 pregnancies with iSUA met the selection criteria. Studies varied in design, quality, outcome definition, and results. Meta-analysis carried out within predefined groups showed that the presence of an iSUA was associated with small for gestational age (OR, 2.75; 95% CI, 1.97 to 3.83; P < 0.00001), preterm birth (OR, 2.10; 95% CI, 1.72 to 2.57; P < 0.00001), pregnancy-induced hypertension (OR, 1.62; 95% CI, 1.00 to 2.63; P=0.05), neonatal intensive care unit admission (OR, 2.06; 95% CI, 1.33 to 3.19; P = 0.001), and perinatal mortality (OR, 2.29; 95% CI, 1.32 to 3.98; P=0.003). Conclusion Pregnancies complicated by iSUA are at increased risk for small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission and perinatal mortality. Further, large prospective cohort studies are required to improve the quality of prenatal counseling and the neonatal care for pregnancies with iSUA.

AB - Objective The aim of this study was to evaluate the association between prenatally diagnosed isolated single umbilical artery (iSUA) and perinatal outcomes. Methods We searched Medline, Embase, the Cochrane Library, and KoreaMed from inception to January 2016, with no language or regional restrictions, for cohort and case-control studies reporting on the relationship of iSUA and perinatal outcomes. We assessed the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission, and perinatal mortality in fetuses with iSUA compared with those in fetuses with three vessel cord. Results Eleven articles totaling 1,731 pregnancies with iSUA met the selection criteria. Studies varied in design, quality, outcome definition, and results. Meta-analysis carried out within predefined groups showed that the presence of an iSUA was associated with small for gestational age (OR, 2.75; 95% CI, 1.97 to 3.83; P < 0.00001), preterm birth (OR, 2.10; 95% CI, 1.72 to 2.57; P < 0.00001), pregnancy-induced hypertension (OR, 1.62; 95% CI, 1.00 to 2.63; P=0.05), neonatal intensive care unit admission (OR, 2.06; 95% CI, 1.33 to 3.19; P = 0.001), and perinatal mortality (OR, 2.29; 95% CI, 1.32 to 3.98; P=0.003). Conclusion Pregnancies complicated by iSUA are at increased risk for small for gestational age, preterm birth, pregnancy-induced hypertension, neonatal intensive care unit admission and perinatal mortality. Further, large prospective cohort studies are required to improve the quality of prenatal counseling and the neonatal care for pregnancies with iSUA.

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