title: Congenital oral mucosal abnormalities in true umbilical cord knots.
abstract: OBJECTIVE
  The pathogenesis and clinical significance of true umbilical cord knots remain controversial. Here, we tested the hypothesis of the presence of congenital oral mucosal changes in newborns with true umbilical cord knots.
  
  
  METHODS
  Seven consecutive infants with true umbilical cord knots and 50 gestational age- and sex-matched controls were enrolled. The proportion of oral frenulum abnormalities and the two-dimensional vascular network geometry [fractal dimension, D, at two scales: D(1-46), and D(1-15), with the relative Lempel-Ziv complexity, (L-Z)], were analyzed.
  
  
  RESULTS
  Infants with true umbilical cord knots showed significantly higher proportions of mandibular frenulum agenesis compared to controls (p = 0.000006). The oral vascular networks of these infants exhibited a significantly higher D(1-46) and D(1-15) (p < 0.0001, respectively), and higher L-Z values (p < 0.0001) than control networks.
  
  
  CONCLUSIONS
  These findings indicate the presence of significant congenital oral mucosal changes in newborn infants with true umbilical cord knots, thus suggesting a previously unrecognized association between true umbilical cord knots and a subclinical extracellular matrix disorder.
authors.affiliation: Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: De Felice
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bianciardi
authors.forename: Stefano
authors.initials: S
authors.lastname: Parrini
authors.forename: Ricardo N
authors.initials: RN
authors.lastname: Laurini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Latini
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007742:Labial Frenum / Q000002:abnormalities; D008035:Lingual Frenum / Q000002:abnormalities; D008297:Male; D009061:Mouth Mucosa / Q000002:abnormalities*; D014102:Torsion Abnormality; D014470:Umbilical Cord / Q000002:abnormalities*