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Am J Perinatol 2021; 38(06): 597-601
DOI: 10.1055/s-0039-1700857
Original Article

Isolated Single Umbilical Artery as a Risk Factor for Urinary Tract Infections in Childhood

Nata Tifferet Willner   *
1   Faculty of Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Tamar Wainstock‡   *
2   Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Asnat Walfisch
3   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Eyal Sheiner
3   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Daniella Landau
4   Department of Neonatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Ofer Beharier
3   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Abstract

Objective This study aimed to determine whether isolated single umbilical artery (iSUA), even absent identifiable genitourinary (GU) abnormalities, increases the risk of GU infection during childhood.

Study Design Retrospective population-based comparison of fetuses with iSUA versus normal three-vessel cords. Fetuses with growth restriction, prematurity, multiple gestations, and anatomical or chromosomal anomalies were excluded. The primary outcome was hospital-associated GU infection during the first 18 years of life. Kaplan–Meier's survival curves were used to assess cumulative risk; Cox's multivariable models were used to adjust for confounders.

Results Among 227,599 term singleton deliveries, children with iSUA (n = 729) had a higher incidence (1.8 vs. 0.6%, p < 0.001) and cumulative incidence (log-rank test, p < 0.001) of hospital-associated GU infection. The Cox's models confirmed these findings (hazard ratio: >2.82, confidence interval: 1.63–4.87 in composite models).

Conclusion iSUA represents an independent risk factor for GU infection. Urinary tract imaging may be warranted.

Keywords

single umbilical artery - genitourinary infection - urinary tract infection - umbilical vessel - fetus

Note

This study was conducted as part of the requirements for MD degree from the Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev.


* These authors contributed equally to this study.


Supplementary Material



Publication History

Received: 16 March 2019

Accepted: 22 September 2019

Article published online:
22 November 2019

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