{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:01:16Z","timestamp":1791244876574,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T00:00:00Z","timestamp":1685750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Objectives: To assess the incidence of prenatally diagnosed isolated single umbilical artery (iSUA) and its impact on major pregnancy outcomes, as well as to investigate potential risk factors. Materials and methods: A prospective study of singleton pregnancies, undergoing routine anomaly scans at 20+0\u201324+0 weeks of gestation, was carried out from 2018 to 2022. The effect of sonographically detected iSUA on small-for-gestational-age neonates (SGA) and preterm delivery (PTD) was evaluated using parameterized Student\u2019s t-test, nonparametric Mann\u2013Whitney U test and the chi-square test. Multivariable logistic regression models were implemented to assess the independent association between iSUA and the main outcomes, as well as with potential risk factors, while adjusting for specific confounders. Results: The study population included 6528 singleton pregnancies and the incidence of prenatally diagnosed iSUA was 1.3%. Prenatally diagnosed iSUA had a statistically significant association with both SGA neonates (aOR: 1.909; 95% CI: 1.152\u20133.163) and PTD (aOR: 1.903; 95% CI: 1.035\u20133.498), while no association was identified between this sonographic finding and preeclampsia. With regard to risk factors, conception via assisted reproductive technology (ART) was associated with increased risk of iSUA (aOR: 2.234; 95% CI: 1.104\u20134.523), while no other independent predictor for the development of this anatomical variation was identified. Conclusions: Prenatally diagnosed iSUA seems to be associated with a higher incidence of SGA and PTD and is more common in pregnancies following ART, which constitutes a novel finding.<\/jats:p>","DOI":"10.3390\/medicina59061080","type":"journal-article","created":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T01:53:25Z","timestamp":1685930005000},"page":"1080","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prenatal Diagnosis of Isolated Single Umbilical Artery: Incidence, Risk Factors and Impact on Pregnancy Outcomes"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3066-9963","authenticated-orcid":false,"given":"Antonios","family":"Siargkas","sequence":"first","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Giouleka","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-7871","authenticated-orcid":false,"given":"Ioannis","family":"Tsakiridis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2605-0765","authenticated-orcid":false,"given":"Apostolos","family":"Mamopoulos","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6007-5341","authenticated-orcid":false,"given":"Ioannis","family":"Kalogiannidis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos","family":"Athanasiadis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2863-5839","authenticated-orcid":false,"given":"Themistoklis","family":"Dagklis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,3]]},"reference":[{"key":"ref_1","unstructured":"Eva, T.R., Waldo, S., Deborah, L., and Louise, W.-H. (2020). Single Umbilical Artery, Wolters Kluwer."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fahmy, M. (2018). Umbilicus and Umbilical Cord, Springer International Publishing.","DOI":"10.1007\/978-3-319-62383-2"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1097\/AOG.0b013e3181f0bc08","article-title":"Single umbilical artery risk factors and pregnancy outcomes","volume":"116","author":"Dodds","year":"2010","journal-title":"Obstet. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/uog.7717","article-title":"Isolated single umbilical artery and fetal karyotype","volume":"36","author":"Dagklis","year":"2010","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1002\/uog.7711","article-title":"Isolated single umbilical artery: Need for specialist fetal echocardiography?","volume":"36","author":"DeFigueiredo","year":"2010","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_6","first-page":"441","article-title":"Prevalence of single umbilical artery, clinical outcomes and its risk factors: A cross-sectional study","volume":"19","author":"Vafaei","year":"2021","journal-title":"Int. J. Reprod. Biomed."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1111\/aogs.13747","article-title":"Isolated single umbilical artery and the risk of adverse perinatal outcome and third stage of labor complications: A population-based study","volume":"99","author":"Ebbing","year":"2020","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_8","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","year":"2022","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1055\/s-2008-1061504","article-title":"Pregnancy outcome in isolated single umbilical artery","volume":"25","author":"Bombrys","year":"2008","journal-title":"Am. J. Perinatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1097\/AOG.0b013e3181da50ed","article-title":"Single umbilical artery and its associated findings","volume":"115","author":"Hua","year":"2010","journal-title":"Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"7396","DOI":"10.1038\/s41598-017-07053-7","article-title":"The Risk Factors and Neonatal outcomes of Isolated Single Umbilical Artery in Singleton Pregnancy: A Meta-analysis","volume":"7","author":"Luo","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/uog.20243","article-title":"Prediction of small-for-gestational-age neonates at 35-37 weeks\u2019 gestation: Contribution of maternal factors and growth velocity between 20 and 36 weeks","volume":"53","author":"Ciobanu","year":"2019","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/S0140-6736(02)11476-0","article-title":"Preterm delivery","volume":"360","author":"Slattery","year":"2002","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Riley, R.D., van der Windt, D., and Croft, P.M.K. (2019). Prognosis Research in Healthcare: Concepts, Methods, and Impact, Oxford University Press.","DOI":"10.1093\/med\/9780198796619.001.0001"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/00001648-199607000-00006","article-title":"A Comparison of Risk Factors for Preterm Labor and Term Small-for-Gestational-Age Birth","volume":"7","author":"Lang","year":"1996","journal-title":"Epidemiology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1002\/uog.17515","article-title":"Perinatal outcome and placental apoptosis in patients with late-onset pre-eclampsia and abnormal uterine artery Doppler at diagnosis","volume":"51","author":"Rodriguez","year":"2018","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_18","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","year":"2023","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_19","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","year":"2023","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1093\/aje\/kwh180","article-title":"Vaginal bleeding during pregnancy and preterm birth","volume":"160","author":"Yang","year":"2004","journal-title":"Am. J. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"g7594","DOI":"10.1136\/bmj.g7594","article-title":"Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): The TRIPOD statement","volume":"350","author":"Collins","year":"2015","journal-title":"BMJ"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1515\/jpm-2021-0260","article-title":"Adverse perinatal outcomes following the prenatal diagnosis of isolated single umbilical artery in singleton pregnancies: A systematic review and meta-analysis","volume":"50","author":"Dagklis","year":"2022","journal-title":"J. Perinat. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lin, L., Lu, C., Chen, W., Li, C., and Guo, V.Y. (2021). Parity and the risks of adverse birth outcomes: A retrospective study among Chinese. BMC Pregnancy Childbirth, 21.","DOI":"10.1186\/s12884-021-03718-4"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1055\/s-0031-1284224","article-title":"The relationship between maternal body mass index and tobacco use on small-for-gestational-age infants","volume":"29","author":"Goetzinger","year":"2012","journal-title":"Am. J. Perinatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1002\/uog.14847","article-title":"Prediction of small-for-gestational-age neonates: Screening by uterine artery Doppler and mean arterial pressure at 35\u201337 weeks","volume":"45","author":"Fadigas","year":"2015","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"266","DOI":"10.5468\/ogs.2017.60.3.266","article-title":"Association of isolated single umbilical artery with perinatal outcomes: Systemic review and meta-analysis","volume":"60","author":"Kim","year":"2017","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1097\/AOG.0000000000001037","article-title":"Association of Isolated Single Umbilical Artery With Small for Gestational Age and Preterm Birth","volume":"126","author":"Battarbee","year":"2015","journal-title":"Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.ejogrb.2014.11.007","article-title":"Isolated single umbilical artery: Evaluating the risk of adverse pregnancy outcome","volume":"184","author":"Worda","year":"2015","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1002\/pd.4352","article-title":"The impact of isolated single umbilical artery on labor and delivery outcome","volume":"34","author":"Ashwal","year":"2014","journal-title":"Prenat. Diagn."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Contro, E., Larcher, L., Lenzi, J., Valeriani, M., Farina, A., and Jauniaux, E. (2023). Changes in Artery Diameters and Fetal Growth in Cases of Isolated Single Umbilical Artery. Diagnostics, 13.","DOI":"10.3390\/diagnostics13030571"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/pd.540","article-title":"Antenatal detection of a single umbilical artery: Does it matter?","volume":"23","author":"Gornall","year":"2003","journal-title":"Prenat. Diagn."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.placenta.2017.09.001","article-title":"Placental abnormalities associated with isolated single umbilical artery in small-for-gestational-age births","volume":"59","author":"Battarbee","year":"2017","journal-title":"Placenta"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.12659\/MSM.897324","article-title":"Association Between Isolated Single Umbilical Artery and Perinatal Outcomes: A Meta-Analysis","volume":"22","author":"Xu","year":"2016","journal-title":"Med. Sci. Monit."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1002\/uog.12541","article-title":"Relationship of isolated single umbilical artery to fetal growth, aneuploidy and perinatal mortality: Systematic review and meta-analysis","volume":"42","author":"Voskamp","year":"2013","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1055\/s-2008-1061502","article-title":"Serial sonographic growth assessment in pregnancies complicated by an isolated single umbilical artery","volume":"25","author":"Wiegand","year":"2008","journal-title":"Am. J. Perinatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.ejogrb.2013.09.028","article-title":"Outcomes of an isolated single umbilical artery in singleton pregnancy: A large study from the Middle East and Gulf region","volume":"171","author":"Khalil","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/QAI.0000000000002072","article-title":"Risk Factors for Adverse Birth Outcomes in the PROMISE 1077BF\/1077FF Trial","volume":"81","author":"Sebikari","year":"2019","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/ijgo.13184","article-title":"Risk factors for spontaneous preterm delivery","volume":"150","author":"Cobo","year":"2020","journal-title":"Int. J. Gynaecol. Obstet. Off. Organ Int. Fed. Gynaecol. Obstet."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1097\/01.AOG.0000183593.24583.7c","article-title":"Assisted reproductive technology and pregnancy outcome","volume":"106","author":"Shevell","year":"2005","journal-title":"Obstet. Gynecol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/OGX.0000000000001023","article-title":"Preterm Labor: A Comprehensive Review of Guidelines on Diagnosis, Management, Prediction and Prevention","volume":"77","author":"Giouleka","year":"2022","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_41","unstructured":"Osuchukwu, O.O., and Reed, D.J. (2022). StatPearls, StatPearls Publishing."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/6\/1080\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:48:24Z","timestamp":1760125704000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/6\/1080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,3]]},"references-count":41,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["medicina59061080"],"URL":"https:\/\/doi.org\/10.3390\/medicina59061080","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,3]]}}}