title: Nuchal cord evident at birth impacts on fetal size relative to that of the placenta.
abstract: We sought to determine whether umbilical cord complications, as evidenced by a nuchal cord at the time of birth, affects birth weight, placental weight and, therefore, the birth to placental weight ratio as a mechanism whereby fetal and placental growth may be differentially affected. The computerized perinatal database of St. Joseph's Health Centre, London, Ontario, was used to obtain the birth weight, placental weight, umbilical cord gases, and nuchal cord status, for all term singleton liveborn infants between January, 1991 and December, 1994. The effect of no nuchal cord versus nuchal cord on birth weight, placental weight, and the birth to placental weight ratio was determined, along with the interactive effects of gestational age and umbilical cord gases, and the 'dose response' effect of the number of cord encirclements. Infants with the cord around the neck were smaller (P < 0.001), their placentas larger (P = 0.001), and their birth to placenta weight ratio also smaller (P < 0.001), with a 'dose response' relationship apparent as these effects were greater in those infants with more than one cord encirclement. Although gestational age and umbilical cord veno-arterial PO2 and PCO2 differences were also found to impact on birth weight, placental weight, and the birth to placental weight ratio, these effects were independent of the effect of nuchal cord complications. Umbilical cord complications is evidenced by a nuchal cord at the time of birth, are associated with a decrease in fetal size relative to that of the placenta, although this is likely to be of little biological significance for most nuchal cord infants.
authors.affiliation: Department of Obstetrics and Gynaecology, St. Joseph's Health Centre, University of Western Ontario, London, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Osak
authors.forename: K M
authors.initials: KM
authors.lastname: Webster
authors.forename: A D
authors.initials: AD
authors.lastname: Bocking
authors.forename: M K
authors.initials: MK
authors.lastname: Campbell
authors.forename: B S
authors.initials: BS
authors.lastname: Richardson
mesh_terms: D000704:Analysis of Variance; D001724:Birth Weight; D003251:Constriction, Pathologic; D005314:Embryonic and Fetal Development; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009333:Neck; D010920:Placenta / Q000033:anatomy & histology; D011247:Pregnancy; D011248:Pregnancy Complications; D014470:Umbilical Cord