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Poster Session 4

Category: Ultrasound/Imaging

Poster Session 4

(1258) Single Umbilical Artery: Marker of Risk or a Benign Variant? A Long-Term Neurologic Follow-Up

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Shayna Miodownik, MD, MSc

Soroka University Medical Center
Soroka University Medical Center, HaDarom, Israel

Coauthor(s)

Gil Gutvirtz, MD, MHA

Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University
Metar, 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
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

Objective:
The clinical significance of a single umbilical artery (SUA) remains a subject of ongoing investigation. SUA is recognized as a potential marker for chromosomal and congenital abnormalities. However, even when SUA is an isolated finding, its relationship with perinatal morbidity remains inconclusive, and data on the long-term outcomes for the offspring is also limited. In this study, we evaluated the association between isolated SUA and long-term neurologic morbidity in the offspring.

Study Design:
A retrospective cohort study including singleton deliveries between 1991-2021 was performed. Fetuses with chromosomal or congenital abnormalities were excluded. Children with SUA were analyzed against children without SUA using neurologic morbidity data from ambulatory and hospitalization records, up to 18 years of age. A Kaplan-Meier survival curve was used to compare cumulative neurologic morbidity incidence. A Cox regression model was used to estimate the risk for long-term neurologic morbidity, controlling for confounders.

Results:
A total of 232,476 singleton pregnancies were included; SUA was identified in 136 of pregnancies. Offspring with SUA had higher rates of long-term neurologic morbidity as compared to offspring without a SUA (Table). However, the cumulative incidence of neurologic morbidity over time was comparable between the groups (Figure), and applying the Cox regression model that controlled for maternal and gestational age, diabetes mellitus, hypertensive disorders, mode of delivery and small for gestational age neonates, reassured that SUA was not associated with a higher risk for offspring neurologic morbidity (aHR=1.11, 95%CI 0.81–1.52; p=0.503).

Conclusion:
Although SUA was associated with a higher unadjusted rate of neurologic morbidity, this association disappeared after controlling for confounders. The cumulative risk over time was similar in both groups, suggesting that isolated SUA is not an independent predictor of adverse long-term neurologic outcomes.