title: Epidemiological association between isolated skin marks in newborn infants and single umbilical artery (SUA). Does it have biological plausibility?
abstract: In a previous study on single umbilical artery (SUA) and its association with congenital defects, we observed a serendipitous association between isolated skin anomalies and the presence of SUA. Although this could be a spurious association, we considered that it deserved to be studied in detail. The aim of this study was to investigate, in an epidemiological setting, whether this association has any biological meaning or if it occurs just by chance. Using data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), we analyzed "angiomas" (including all type of capillary skin marks, since it is not possible to distinguish it during the first 3 days of life), and nevi because they are the only defects detected in newborn infants as isolated skin defects. In the ECEMC methodology, infants with nevi or angiomas as the only congenital defect are considered as cases when they present with only one of these skin marks measuring at least 1 cm in diameter and within the first 3 days of life, or when they have three or more such marks of any size. A total sample of 1,832 consecutive newborn infants with isolated congenital skin marks was identified: 871 with nevi, 958 with angiomas, and 3 with both. Newborn infants with SUA and isolated angiomas displayed higher birth measurements, and older maternal and paternal ages than newborn infants with angiomas and three umbilical vessels. Similar results were observed when infants with angiomas and SUA were compared with control infants either with or without SUA. These associations were not observed in newborn infants with nevi with or without SUA or for control infants with or without SUA. The distribution of the angiomas by body areas, and sex preferences were also analyzed. After evaluating the limitations and advantages of the present study, the results suggest that newborn infants with angiomas (irrespective of their type), SUA, and higher centile measurements may have one of the syndromes that exhibit this type of skin mark. Although this observation requires confirmation, we do suggest close attention to newborns with these three signs.
authors.affiliation: ECEMC, Centro de Investigación sobre Anomalías Congénitas (CIAC), Instituto de Salud Carlos III, Madrid, Spain. mlmartinez.frias@isciii.es
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Martínez-Frías
mesh_terms: D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D006391:Hemangioma / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009506:Nevus / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology; D014469:Umbilical Arteries / Q000002:abnormalities*