Associations between velamentous or marginal cord insertion and risk of adverse perinatal outcomes in twin pregnancies: a retrospective cohort study

作者全名："Wen, Li; Zhong, Qimei; Mei, Lingwei; Gao, Li; Lan, Xia; Xiong, Jing; Luo, Shujuan; Wang, Lan"

作者地址："[Wen, Li; Zhong, Qimei; Mei, Lingwei; Gao, Li; Lan, Xia; Xiong, Jing; Luo, Shujuan; Wang, Lan] Chongqing Med Univ, Dept Obstet & Gynecol, Women & Childrens Hosp, Chongqing 401147, Peoples R China; [Wen, Li; Zhong, Qimei; Mei, Lingwei; Gao, Li; Lan, Xia; Xiong, Jing; Luo, Shujuan; Wang, Lan] Chongqing Hlth Ctr Women & Children, Dept Obstet & Gynecol, Chongqing 401147, Peoples R China"

通信作者："Wang, L (通讯作者)，Chongqing Med Univ, Dept Obstet & Gynecol, Women & Childrens Hosp, Chongqing 401147, Peoples R China.; Wang, L (通讯作者)，Chongqing Hlth Ctr Women & Children, Dept Obstet & Gynecol, Chongqing 401147, Peoples R China."

来源：BMC PREGNANCY AND CHILDBIRTH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001065357200004

JCR分区：Q1

影响因子：2.8

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Velamentous cord insertion; Marginal cord insertion; Selective fetal growth restriction; Small-for-gestational age; Preeclampsia; Twin pregnancies

摘要："BackgroundVelamentous cord insertion (VCI) and marginal cord insertion (MCI) are well-known risk factors for adverse perinatal outcomes in singleton pregnancies. However, the potential links between VCI or MCI and perinatal outcomes in twin pregnancies have yet to be systematically evaluated. This study aimed to investigate the relationships between VCI or MCI and perinatal outcomes in twin pregnancies.MethodsThis retrospective single-center cohort study included women with twin pregnancies who gave birth in a tertiary hospital in Southwest, China between January 2017 and December 2022. VCI and MCI were identified by abdominal ultrasound and confirmed after placental delivery. Logistic regression, multinomial logit regression and generalized estimation equation models were used to evaluate the association between VCI or MCI and perinatal outcomes.ResultsA total of 3682 twin pregnancies were included, including 100 (2.7%) pregnancies with VCI and 149 (4.0%) pregnancies with MCI. Compared to pregnancies with normal cord insertion, both monochorionic and dichorionic pregnancies with VCI were associated with an increased risk of preterm delivery 32-34 weeks (aRRR 2.94, 95% CI 1.03-8.39; aRRR 2.55, 95% CI 1.19-5.46, respectively), while pregnancies with MCI were not associated with preterm delivery. VCI was associated with a higher incidence of placental previa (aOR 6.36, 95% CI 1.92-21.04) in monochorionic pregnancies and placental accreta (aOR 1.85, 95% CI 1.06-3.23) in dichorionic pregnancies. MCI was associated with an increased risk of preeclampsia (aOR 3.07, 95% CI 1.49-6.32), intertwin birthweight discordance & GE; 20% (aOR 2.40, 95% CI 1.08-5.60) and selective fetal growth restriction (aOR 2.46, 95% CI 1.08-5.60) in monochorionic pregnancies and small-for-gestational age neonates (aOR 1.97, 95% CI 1.24-3.14) in dichorionic pregnancies.ConclusionsVCI was associated with an increased risk of preterm delivery in twin pregnancies irrespective of chorionicity, whereas MCI was associated with an increased preeclampsia risk, significant intertwin birthweight discordance in monochorionic pregnancies and small-for-gestational age neonates in dichorionic pregnancies."

基金机构：The authors would like to thank all the participants in this study.

基金资助正文：The authors would like to thank all the participants in this study.