{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:51:37Z","timestamp":1781869897991,"version":"3.54.5"},"reference-count":15,"publisher":"FapUNIFESP (SciELO)","issue":"3","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to investigate the importance of routine evaluation of cord insertion during the prenatal period. To this end, the perinatal outcomes of marginal and velamentous cord insertions were compared to normal cord insertions.  METHODS: We conducted a retrospective cohort study of singleton pregnancies delivered after 24 weeks between 2016 and 2023, comparing marginal and velamentous cord insertions diagnosed on second-trimester ultrasound with normal cord insertions in terms of preterm birth and adverse perinatal outcomes, after excluding cases with fetal anomalies, placenta previa, placental invasion, vasa previa, or multiple gestations.  RESULTS: Among 6,675 singleton pregnancies, 367 (5.5%) had marginal cord insertion and 45 (0.7%) had velamentous cord insertion. Marginal cord insertion was associated with a nearly threefold higher risk of preterm birth before 37 weeks, while no significant differences were observed for other adverse outcomes. In contrast, velamentous cord insertion was linked to significantly increased risks of preterm birth, primary cesarean delivery, low Apgar scores, and neonatal intensive care unit admission compared with normal cord insertions.  CONCLUSION: Marginal and velamentous cord insertions showed associations with preterm birth and certain adverse perinatal outcomes. Routine evaluation of cord insertion may provide useful information for clinical follow-up.  Clinical Trial Registration: This study was retrospectively registered and authorized by the local Ethics Committee of Ankara University (clinical trial date 19.08.2025; number: 1942038).<\/jats:p>","DOI":"10.1590\/1806-9282.20251878","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:01:53Z","timestamp":1781866913000},"source":"Crossref","is-referenced-by-count":0,"title":["Cord insertion anomalies and adverse pregnancy outcomes: more than an incidental finding"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0982-3356","authenticated-orcid":false,"given":"Hasan","family":"S\u00fct","sequence":"first","affiliation":[{"name":"Ankara University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6466-6050","authenticated-orcid":false,"given":"Mustafa","family":"Ko\u00e7ar","sequence":"additional","affiliation":[{"name":"Ankara University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3283-7783","authenticated-orcid":false,"given":"G\u00fcl\u015fah Aynao\u011flu","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"Ankara University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"2","key":"ref1","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1055\/a-2599-4764","article-title":"Perinatal outcomes based on placental cord insertion site.","volume":"43","author":"Pressman K","year":"2026","journal-title":"Am J Perinatol"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1186\/s13643-017-0641-1","article-title":"Abnormal placental cord insertion and adverse pregnancy outcomes: a systematic review and meta-analysis.","volume":"6","author":"Ismail KI","year":"2017","journal-title":"Syst Rev"},{"issue":"1","key":"ref3","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s13643-020-01355-0","article-title":"Velamentous cord insertion: results from a rapid review of incidence, risk factors, adverse outcomes and screening.","volume":"9","author":"Buchanan-Hughes A","year":"2020","journal-title":"Syst Rev"},{"issue":"4","key":"ref4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1002\/ajum.12399","article-title":"Placental cord insertion migration: implications for ultrasound documentation and follow-up of abnormal placental cord insertion site.","volume":"27","author":"Ward S","year":"2024","journal-title":"Australas J Ultrasound Med"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s12884-021-03703-x","article-title":"Marginal cord insertion among singleton births at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.","volume":"21","author":"Aragie H","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.1002\/jum.15586","article-title":"Measurement of marginal placental cord insertion by prenatal ultrasound was found not to be predictive of adverse perinatal outcomes.","volume":"40","author":"Lutz AB","year":"2021","journal-title":"J Ultrasound Med"},{"issue":"4","key":"ref7","doi-asserted-by":"crossref","first-page":"100876","DOI":"10.1016\/j.ajogmf.2023.100876","article-title":"Impact of marginal cord insertion on perinatal outcomes: a systematic review and meta-analysis.","volume":"5","author":"Siargkas A","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"6","key":"ref8","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1002\/uog.24888","article-title":"ISUOG Practice Guidelines (updated): performance of the routine mid-trimester fetal ultrasound scan.","volume":"59","author":"Salomon LJ","year":"2022","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"ref9","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/ajum.12360","article-title":"Current practice of placental cord insertion documentation in Australia - A sonographer survey.","volume":"26","author":"Ward S","year":"2023","journal-title":"Australas J Ultrasound Med"},{"issue":"23","key":"ref10","doi-asserted-by":"crossref","first-page":"7438","DOI":"10.3390\/jcm13237438","article-title":"Risk factors of marginal cord insertion in singleton pregnancies: a systematic review and meta-analysis.","volume":"13","author":"Siargkas A","year":"2024","journal-title":"J Clin Med"},{"issue":"9","key":"ref11","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1080\/14767058.2020.1763297","article-title":"Marginal placental cord insertion: the need for follow up?","volume":"35","author":"Asoglu MR","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1136\/jclinpath-2020-207342","article-title":"Abnormal umbilical cord insertions in singleton deliveries: placental histology and neonatal outcomes.","volume":"75","author":"Visentin S","year":"2022","journal-title":"J Clin Pathol"},{"issue":"1197","key":"ref13","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1093\/postmj\/qgae193","article-title":"Effect of abnormal placental cord insertion on hemodynamic change of umbilical cord in a tertiary center: a prospective cohort study.","volume":"101","author":"Wu XQ","year":"2025","journal-title":"Postgrad Med J"},{"issue":"2","key":"ref14","doi-asserted-by":"crossref","first-page":"100812","DOI":"10.1016\/j.ajogmf.2022.100812","article-title":"Impact of velamentous cord insertion on perinatal outcomes: a systematic review and meta-analysis.","volume":"5","author":"Siargkas A","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"2","key":"ref15","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1002\/uog.26206","article-title":"Peripheral cord insertion is associated with adverse pregnancy outcome only when accompanied by clinically significant placental pathology.","volume":"62","author":"Stapleton D","year":"2023","journal-title":"Ultrasound Obstet Gynecol"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302026000302223&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:01:55Z","timestamp":1781866915000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302026000302223&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]}},"alternative-id":["S0104-42302026000302223"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20251878","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20251878"}}