Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study

<b>Objective</b>: To evaluate and compare whether the presence of a nuchal cord (NC) and its characteristics had a negative impact on perinatal outcomes during delivery. <b>Methods</b>: This was a retrospective cohort study that analyzed the medical records of pregnant women...

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Main Authors: Gabriel Viana Silva, Carolina Toledo Gontijo, Ana Paola Cruz Lunguinho, Mário Sérgio Gomes Caetano, Gustavo Yano Callado, Edward Araujo Júnior, Alberto Borges Peixoto
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/10/1197
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author Gabriel Viana Silva
Carolina Toledo Gontijo
Ana Paola Cruz Lunguinho
Mário Sérgio Gomes Caetano
Gustavo Yano Callado
Edward Araujo Júnior
Alberto Borges Peixoto
author_facet Gabriel Viana Silva
Carolina Toledo Gontijo
Ana Paola Cruz Lunguinho
Mário Sérgio Gomes Caetano
Gustavo Yano Callado
Edward Araujo Júnior
Alberto Borges Peixoto
author_sort Gabriel Viana Silva
collection DOAJ
description <b>Objective</b>: To evaluate and compare whether the presence of a nuchal cord (NC) and its characteristics had a negative impact on perinatal outcomes during delivery. <b>Methods</b>: This was a retrospective cohort study that analyzed the medical records of pregnant women from March 2020 to June 2023. Pregnant women were divided into groups with and without an NC. Singleton pregnancies ≥ 37 weeks were included, excluding fetal malformations, chromosomal anomalies, and cases with missing data and cord blood gas. <b>Results</b>: Of the 3364 medical records analyzed, 466 were included—366 without and 100 with an NC. Among the cases with an NC, 91% had one loop and 9% had ≥ two loops; 82% were loose and 18% were tight. Pregnant women with an NC had a higher gestational age (39.7 vs. 39.1 weeks, <i>p</i> = 0.006), fewer deliveries (1.0 vs. 2.0, <i>p</i> = 0.035), and a higher prevalence of cesarean sections (99% vs. 60.4%, <i>p</i> < 0.001). An NC was associated with a lower Apgar score at the 1st minute (8 vs. 9, <i>p</i> = 0.014) and higher arterial cord blood pH (7.27 vs. 7.24, <i>p</i> = 0.020). The presence of a tight cord was significantly associated with a 7.52-fold increased risk of an Apgar score < 7 at the 1st minute [x<sup>2</sup>(1) = 5.92, OR: 7.52, 95% CI: 1.51–37.31, R<sup>2</sup> Nagelkerke: 0.14, <i>p</i> = 0.014]. <b>Conclusions</b>: There was no effect of the presence of an NC on adverse perinatal outcomes. However, the presence of a tight NC was associated with an increased risk of an Apgar score < 7 at the 1st minute, but no other effect on neonatal outcomes.
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spelling doaj-art-d6dee4ab2cb743e0969624f58c5c30e62025-08-20T03:14:31ZengMDPI AGDiagnostics2075-44182025-05-011510119710.3390/diagnostics15101197Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort StudyGabriel Viana Silva0Carolina Toledo Gontijo1Ana Paola Cruz Lunguinho2Mário Sérgio Gomes Caetano3Gustavo Yano Callado4Edward Araujo Júnior5Alberto Borges Peixoto6Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba 38025-440, MG, BrazilDepartment of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba 38025-440, MG, BrazilDepartment of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba 38025-440, MG, BrazilDepartment of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba 38025-440, MG, BrazilAlbert Einstein Israelite College of Health Sciences, Albert Einstein Israelite Hospital, São Paulo 05653-120, SP, BrazilDepartment of Obstetrics, Paulista School of Medicine—Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, SP, BrazilDepartment of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba 38025-440, MG, Brazil<b>Objective</b>: To evaluate and compare whether the presence of a nuchal cord (NC) and its characteristics had a negative impact on perinatal outcomes during delivery. <b>Methods</b>: This was a retrospective cohort study that analyzed the medical records of pregnant women from March 2020 to June 2023. Pregnant women were divided into groups with and without an NC. Singleton pregnancies ≥ 37 weeks were included, excluding fetal malformations, chromosomal anomalies, and cases with missing data and cord blood gas. <b>Results</b>: Of the 3364 medical records analyzed, 466 were included—366 without and 100 with an NC. Among the cases with an NC, 91% had one loop and 9% had ≥ two loops; 82% were loose and 18% were tight. Pregnant women with an NC had a higher gestational age (39.7 vs. 39.1 weeks, <i>p</i> = 0.006), fewer deliveries (1.0 vs. 2.0, <i>p</i> = 0.035), and a higher prevalence of cesarean sections (99% vs. 60.4%, <i>p</i> < 0.001). An NC was associated with a lower Apgar score at the 1st minute (8 vs. 9, <i>p</i> = 0.014) and higher arterial cord blood pH (7.27 vs. 7.24, <i>p</i> = 0.020). The presence of a tight cord was significantly associated with a 7.52-fold increased risk of an Apgar score < 7 at the 1st minute [x<sup>2</sup>(1) = 5.92, OR: 7.52, 95% CI: 1.51–37.31, R<sup>2</sup> Nagelkerke: 0.14, <i>p</i> = 0.014]. <b>Conclusions</b>: There was no effect of the presence of an NC on adverse perinatal outcomes. However, the presence of a tight NC was associated with an increased risk of an Apgar score < 7 at the 1st minute, but no other effect on neonatal outcomes.https://www.mdpi.com/2075-4418/15/10/1197nuchal cordtight corddeliveryadverse perinatal outcomes
spellingShingle Gabriel Viana Silva
Carolina Toledo Gontijo
Ana Paola Cruz Lunguinho
Mário Sérgio Gomes Caetano
Gustavo Yano Callado
Edward Araujo Júnior
Alberto Borges Peixoto
Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study
Diagnostics
nuchal cord
tight cord
delivery
adverse perinatal outcomes
title Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study
title_full Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study
title_fullStr Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study
title_full_unstemmed Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study
title_short Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study
title_sort perinatal outcomes related to the presence of a nuchal cord during delivery a retrospective cohort study
topic nuchal cord
tight cord
delivery
adverse perinatal outcomes
url https://www.mdpi.com/2075-4418/15/10/1197
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