Effects of Nuchal Cord on Birthweight and Immediate Neonatal Outcomes

ABSTRACT

Our objective was to ascertain if nuchal cord is associated with adverse neonatal outcomes. Using a retrospective database of term neonates, outcomes were compared among infants with 0, 1, and 2 or more loops of cord encircling the neck. Of 4426 neonates, 3651 served as controls, 691 had one loop, and 84 had two or more loops. There were no significant differences in the mean birthweight, the frequency of nonreassuring fetal heart rate patterns, operative vaginal deliveries, or 5-minute Apgar scores of < 7. The cesarean delivery rate was significantly different among the three groups and was the highest among the group of women whose fetus had no nuchal cord (p < 0.01). A nuchal cord at term is not associated with untoward pregnancy outcomes.

KEYWORDS

Nuchal cord - neonatal outcome - birthweight

REFERENCES

• 1 Clapp J F, Lopez B, Simonean S. Nuchal cord and neurodevelopmental performance at 1 year.  J Soc Gynecol Invest. 1999;  6 268-272
• 2 Larson J D, Rayburn W F, Crosby S, Thurnau G R. Multiple nuchal cord entanglements and intrapartum complications.  Am J Obstet Gynecol. 1995;  173 1228-1231
• 3 Hankins G DV, Snyder R R, Hauth J C, Gilstrap L C, Hammond T. Nuchal cords and neonatal outcome.  Obstet Gynecol. 1987;  70 687-691
• 4 Gonzalez-Quintero V H, Tolaymat L, Muller A C et al.. Outcomes of pregnancies with sonographically detected nuchal cords remote from delivery.  J Ultrasound Med. 2004;  23 43-47
• 5 Clapp III J F, Stepanchak W, Hashimoto K et al.. The natural history of antenatal nuchal cords.  Am J Obstet Gynecol. 2003;  189 488-493
• 6 Jauniaux E, Ramsay B, Peellaerts C, Scholler Y. Perinatal features of pregnancies complicated by nuchal cord.  Am J Perinatol. 1995;  12 255-258
• 7 Rhoades D A, Latza U, Mueller B A. Risk factors and outcomes associated with nuchal cord. A population-based study.  J Reprod Med. 1999;  44 39-45
• 8 Nelson K B, Grether J K. Potentially asphyxiating conditions and spastic cerebral palsy in infants of normal birth weight.  Am J Obstet Gynecol. 1998;  179 507-513
• 9 A report by the American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy and Cerebral Palsy and the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics .Neonatal encephalopathy and cerebral palsy: defining the pathogenesis and pathophysiology. Washington, DC; ACOG January 2003
• 10 Greenwood C, Impey L. The association of nuchal cord with cerebral palsy is influenced by recording bias.  Early Hum Dev. 2002;  68 15-19
• 11 Carey J C, Rayburn W F. Nuchal cord encirclements and birth weight.  J Reprod Med. 2003;  48 460-462