TY - JOUR
T1 - A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery
AU - de los Reyes, Samantha
AU - Henderson, Janice
AU - Eke, Ahizechukwu C.
N1 - Publisher Copyright:
© 2018 International Federation of Gynecology and Obstetrics
PY - 2018/7
Y1 - 2018/7
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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U2 - 10.1002/ijgo.12489
DO - 10.1002/ijgo.12489
M3 - Review article
C2 - 29572823
AN - SCOPUS:85044954189
VL - 142
SP - 9
EP - 14
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
SN - 0020-7292
IS - 1
ER -