Publication:

Effect of long and short umbilical cord on perinatal outcome

Background Most of umbilical cords are 50 to 60 cm long, and very few are abnormally short or long. Short cord is defined as 80 cm. Short cords maybe associated with adverse perinatal outcomes such as IUGR, congenital malformation, intrapartum distress and 2 fold. Cord length is influenced positively by both the volume of amniotic fluid and fetal mobility. Objective was to determine the association between abnormal umbilical cord length and perinatal outcome.

Methods A retrospective cohort study, conducted at McGill University, using the computerized MOND database. All Term singleton deliveries between 2001 and 2007 were included. We based our population according to the length of the umbilical cord following delivery: Normal cord length (measured length 35-80 cm), short cord ( 80 cm). Admission to the Neonatal Intensive Care Unit (NICU) was compared to the normal cord group.

Results Of the 14,873 deliveries included, 13518 (90.9 %) had normal cord lengths, 980 (6.6 %) had short cords, and 375 (2.5%) long cords. Maternal age, gravidity, birth weights, and rate of male gender babies were all increased in the long cord group and decreased in the short cord group (all p<0.05). NICU admissions were more common in the short cord group (OR 1.9; 95%, CI 1.4-2.6) but not in the long cord group. Babies in both the short and long cord groups had higher rates of Apgar score <7 (OR 1.3, 95% CI 1.1-1.7 and OR 1.7, 95% CI 1.2-2.3, respectively) with no significant difference in cord pH. Gravidity and abnormal cord length were independent predictors of NICU admission.

Conclusions Short umbilical cord is associated with higher rates of NICU admissions and low Apgar scores.