EP16.14: Perinatal outcomes based on placental cord insertion site

To compare perinatal outcomes based on placental cord insertion (PCI) site in pregnancies at risks for fetal growth disorders. This is a secondary analysis of singletons with fetal growth assessment between 26 and 36 weeks of gestation. Fetuses with chromosomal or congenital malformations were excluded. Categorical data was analysed with X2 and continuous data with Kruskal Wallis tests. Pairwise comparisons and Bonferroni corrections were utilised. Of the 1054 fetuses, 660 had confirmed placental cord insertion site by pathology review. 609 (92%) had central cord insertion, 37 (5.6%) had marginal, and 14 (2.1%) had velamentous. Demographic, clinical characteristics, and outcomes are presented in table 1. There was no difference in small for gestational age or preterm birth. Those with a velamentous cord insertion (VCI) had lower gestational age at delivery [37.6 vs. 38.6, p = 0.32] than placentas with central cord insertion and higher rates of hypoglycemia than those with other types of PCIs [71.4% vs 26.2% and 20%, p = 0.01]. After controlling for confounding variables, velamentous cord insertion remained predictive for hypoglycemia (aOR = 8.14, 95% CI = 2.04-32.5). VCI was associated with lower gestational age at delivery and higher rates of neonatal hypoglycemia compared to other PCIs. Additional studies are needed to assess the association of marginal and velamentous cord insertion and adverse perinatal outcomes.