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Poster Session 1

Category: Medical/Surgical/Diseases/Complications

Poster Session 1

(325) The association between true knot of cord and nuchal cord and long-term offspring cardiovascular morbidity

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Rachel Rappaport, BS, MD (she/her/hers)

Resident physician
Soroka medical center
Soroka medical center, HaDarom, Israel

Coauthor(s)

Eyal Sheiner, MD, PhD

Deichmann Lerner Full Professor of Obstetrics & Gynecology; Chairman of the Division of OBY&GYN
Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
beer sheva, HaDarom, Israel
Gali Pariente, MD

Acting director of Fetal Maternal Unit B Division of Obstetrics and Gynecology
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University
beer sheva, HaDarom, Israel
Tamar Wainstock, PhD (she/her/hers)

Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev
Beer Sheva, HaDarom, Israel

Objective:
Fetal hypoxic stress during development may disrupt vascular programming and endothelial function, potentially predisposing to long-term cardiovascular morbidity. Nuchal cord and true knot of the umbilical cord can affect fetal cardiovascular function by compromising blood flow, thus leading to potential adverse perinatal outcomes. We aimed to study the long-term cardiovascular morbidity in offspring born with confirmed true knot of cord or nuchal cord.

Study Design:
A population-based cohort study was conducted, evaluating the risk of offspring cardiovascular disease based upon the presence or absence of true knot of cord or nuchal cord at birth. Data for the incidence of cardiovascular morbidity of the offspring was extracted from community-based clinics and hospitalization records. A Kaplan Meir survival curve was constructed to compare the cumulative incidence of cardiovascular morbidity between the study groups. Multivariable Cox regression models were used to assess the independent association between true knot of cord or nuchal cord and cardiovascular morbidity of the offspring, while controlling for confounders.

Results:
The study included 232,476 newborns of whom 1.1% (n=2,537) were diagnosed with true knot of the umbilical cord and 18.2% (n=42,398) were diagnosed with nuchal cording. The cumulative incidence of cardiovascular morbidity of the offspring didn't demonstrate a significant difference between offspring to women with and without true knot of cord or nuchal cord. The Cox proportional hazards models (figure 1), controlling for mode of delivery, maternal age, gestational age at birth, and ethnicity, confirmed a lack of association between true knot of cord or nuchal cord and long-term cardiovascular morbidity of the offspring (adjusted HR 0.93, 95% CI 0.71-2.10, p=0.578 and adjusted HR 0.95, 95% CI 0.88-1.02, p=0.212 for true knot of cord and nuchal cord, respectively).

Conclusion:
In this large population-based cohort, neither true knot of the umbilical cord nor nuchal cord at birth was associated with an increased risk of long-term cardiovascular morbidity in offspring.