Prevalence of Single Umbilical Artery (Isolated and non-isolated) and Its Correlation with Birth Defects and Premature Death

Abstract

Background: The single umbilical artery (SUA) is linked to congenital abnormalities in almost every organ system, however published findings have been inconsistent. Although It has been proposed that inherited and long-term environmental factors do play a role, there is a need for further investigations on the same. The goal is to look into the possibility of a link between a single umbilical artery (SUA) in the incidence of chromosomal anomalies in the second trimester of pregnancy and their collective occurrence.
 Methods: The exclusion of any one of the two umbilical artery and a present umbilical vein was considered as a single umbilical artery for the purpose of this research. A single umbilical artery was established by gross or histologic investigation of the placenta, neonatal evaluation, or autopsy. As a direct consequence, a newborn who did not have a single umbilical artery documented in these records was presumed to have an umbilical cord consisting of three vessels.
 Results: SUA was identified in 0.46 percent of our population (4241/918 933). SUA risk factors included pregestational diabetes in the mother, consistently high blood pressure, prior Cesarean delivery. Some other factors include smoking, epilepsy, and conception via assisted reproductive technology. SUA was associated with gastrointestinal atresia or stenosis in the neonate, esophageal and anorectal atresia or stenosis followed renal agenesis. SUA was linked to an elevated risk of congenital cardiac abnormalities by up to 7–8 times. There was a link between microcephaly, congenital hydrocephalus. There was a link established between other congenital brain and spinal cord anomalies as well. SUA displayed a lesser relationship with hernia associated with the diaphragm, limb reduction defect. It also showed a smaller relation to cleft lip or cleft palate. The risks of trisomy 13 and 21 were both increased, while the risk of trisomy 18 was maximum. Fetuses diagnosed with SUA, whether or not accompanied with a deformity, had two times the higher potential possibility of SUA in a future pregnancy.
 Conclusion: Single Umbilical Artery is closely linked to gastrointestinal atresia or stenosis, implying the same developmental processes. The higher likelihood of reappearance of Single Umbilical Artery implies that inheritable and/or long-term environmental variables play a role. SUA was shown to have high correlations with trisomies 13 and 18.