A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery

Samantha de los Reyes, Janice L Henderson, Ahizechukwu Eke

Research output: Contribution to journalArticle

Abstract

Background: Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes. Objectives: To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI. Search strategy: Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA). Selection criteria: Only studies involving VCI were included in the meta-analysis. Data collection and analysis: Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark). Main results: There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8% vs 7.0%; adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95% CI 1.12-1.23), SGA (aOR 1.93, 95% CI 1.83-2.04), and FDIU (aOR 3.96, 95% CI 3.21-4.89). Conclusion: The presence of VCI was associated with adverse pregnancy outcomes.

Original languageEnglish (US)
JournalInternational Journal of Gynecology and Obstetrics
DOIs
StateAccepted/In press - Jan 1 2018

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Meta-Analysis
Odds Ratio
Confidence Intervals
Pregnancy
Fetal Death
Pregnancy Outcome
Gestational Age
Placentation
Control Groups
Premature Birth
Denmark
Pre-Eclampsia
Patient Selection
Observational Studies
Language
Outcome Assessment (Health Care)
Databases
Incidence

Keywords

  • Adverse pregnancy outcomes
  • Cesarean delivery
  • Preterm birth
  • Velamentous cord insertion

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

@article{d0a0f80d14734e0b8f68079a0441cf4c,
title = "A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery",
abstract = "Background: Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes. Objectives: To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI. Search strategy: Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA). Selection criteria: Only studies involving VCI were included in the meta-analysis. Data collection and analysis: Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark). Main results: There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8{\%} vs 7.0{\%}; adjusted odds ratio [aOR] 1.95, 95{\%} confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95{\%} CI 1.12-1.23), SGA (aOR 1.93, 95{\%} CI 1.83-2.04), and FDIU (aOR 3.96, 95{\%} CI 3.21-4.89). Conclusion: The presence of VCI was associated with adverse pregnancy outcomes.",
keywords = "Adverse pregnancy outcomes, Cesarean delivery, Preterm birth, Velamentous cord insertion",
author = "{de los Reyes}, Samantha and Henderson, {Janice L} and Ahizechukwu Eke",
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AU - Henderson, Janice L

AU - Eke, Ahizechukwu

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N2 - Background: Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes. Objectives: To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI. Search strategy: Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA). Selection criteria: Only studies involving VCI were included in the meta-analysis. Data collection and analysis: Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark). Main results: There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8% vs 7.0%; adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95% CI 1.12-1.23), SGA (aOR 1.93, 95% CI 1.83-2.04), and FDIU (aOR 3.96, 95% CI 3.21-4.89). Conclusion: The presence of VCI was associated with adverse pregnancy outcomes.

AB - Background: Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes. Objectives: To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI. Search strategy: Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA). Selection criteria: Only studies involving VCI were included in the meta-analysis. Data collection and analysis: Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark). Main results: There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8% vs 7.0%; adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95% CI 1.12-1.23), SGA (aOR 1.93, 95% CI 1.83-2.04), and FDIU (aOR 3.96, 95% CI 3.21-4.89). Conclusion: The presence of VCI was associated with adverse pregnancy outcomes.

KW - Adverse pregnancy outcomes

KW - Cesarean delivery

KW - Preterm birth

KW - Velamentous cord insertion

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