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
