Maternal background and perinatal complications in MCI: A retrospective cohort study

IF 3 2区医学 Q2 DEVELOPMENTAL BIOLOGY

Placenta Pub Date : 2025-02-27 DOI:10.1016/j.placenta.2025.02.017

Tatsuya Yoshihara, Yasuhiko Okuda, So Owada, Yosuke Ono, Satoko Sasatsu, Maki Ogi, Eriko Ogasahara, Osamu Yoshino

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引用次数: 0

Abstract

Objective

Marginal cord insertion (MCI) is often defined as an abnormal placental cord insertion (PCI), yet there is limited discussion on the maternal backgrounds and perinatal complications associated with its occurrence. This retrospective cohort study aimed to investigate maternal backgrounds associated with MCI and to compare perinatal outcomes between MCI and normal PCI.

Materials and methods

The study included 1038 deliveries from 2021 to 2023 in our institution, examining maternal backgrounds and perinatal outcomes. Multivariable logistic regression analysis was conducted for variables that showed significance in univariate analysis of maternal backgrounds. For perinatal outcomes, variables that exhibited significance were further analyzed using multivariable logistic regression, considering factors previously reported to be associated with those events.

Results

9.5 % exhibited MCI. Assisted reproductive technology, nulliparous, and congenital uterine anomalies were identified as independent risk factors for MCI. In perinatal outcomes, fetal growth restriction (FGR) and emergency cesarean section were significantly more prevalent in cases with MCI. Even when compared to factors previously reported to be associated with FGR and emergency cesarean section, MCI remained an independent risk factor.

Conclusion

In addition to previously reported factors such as ART and primiparity, uterine anomalies were also identified as risk factors for MCI. It is important to manage MCI with the awareness that it increases the incidence of perinatal complications.

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MCI的母体背景和围产期并发症：一项回顾性队列研究

目的：外缘脐带插入（MCI）常被定义为异常胎盘脐带插入（PCI），但对其发生的产妇背景及围生期并发症的探讨有限。本回顾性队列研究旨在调查与MCI相关的母亲背景，并比较MCI和正常PCI的围产期结局。材料和方法本研究纳入我院2021年至2023年1038例分娩，检查产妇背景和围产期结局。对母亲背景单因素分析中有显著意义的变量进行多变量logistic回归分析。对于围产期结局，考虑到先前报道的与这些事件相关的因素，使用多变量logistic回归进一步分析具有显著性的变量。辅助生殖技术、无产和先天性子宫异常被认为是MCI的独立危险因素。在围产期结局中，MCI病例中胎儿生长受限（FGR）和紧急剖宫产明显更为普遍。即使与先前报道的与FGR和紧急剖宫产相关的因素相比，MCI仍然是一个独立的危险因素。结论除了先前报道的ART和初产等因素外，子宫异常也被确定为MCI的危险因素。认识到MCI会增加围产期并发症的发生率，对其进行管理是很重要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Placenta 医学-发育生物学

CiteScore

6.30

自引率

10.50%

发文量

391

审稿时长

78 days

期刊介绍： Placenta publishes high-quality original articles and invited topical reviews on all aspects of human and animal placentation, and the interactions between the mother, the placenta and fetal development. Topics covered include evolution, development, genetics and epigenetics, stem cells, metabolism, transport, immunology, pathology, pharmacology, cell and molecular biology, and developmental programming. The Editors welcome studies on implantation and the endometrium, comparative placentation, the uterine and umbilical circulations, the relationship between fetal and placental development, clinical aspects of altered placental development or function, the placental membranes, the influence of paternal factors on placental development or function, and the assessment of biomarkers of placental disorders.