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388: The relationship between short inter-pregnancy interval and abnormal placental cord insertion

      Objective

      Abnormal placental cord insertion (PCI) includes marginal insertion (cord insertion less than 2 cm from placental edge), and velamentous insertion (cord insertion into the fetal membranes before traversing to the placental edge). The etiology of abnormal PCI is undetermined. Numerous studies have demonstrated that abnormal PCI can result in adverse outcomes for both mother and baby. A short inter-pregnancy time interval between the birth of one child and the conception of the next child has also been shown to result in subsequent adverse outcomes. This study was designed to determine the association between short inter-pregnancy interval and abnormal PCI.

      Study Design

      In this retrospective case-control study of pregnancies between 03-26-2009 to 08-01-2016, the inter-pregnancy time interval preceding delivery was calculated for women with abnormal PCI – both marginal (n=49) and velamentous cord insertions (n=57), as determined at pathology exam of the placenta. Inter-pregnancy interval was likewise calculated for control multiparous women with normal PCI (n=57). The proportion of pregnancies preceded by a shortened inter-pregnancy interval of 6 months or less was compared between the three groups and analyzed using the Fisher’s exact test.

      Results

      The proportion of pregnancies preceded by a shortened inter-pregnancy interval of 6 months or less was significantly different (p=0.047) in patients with velamentous cord insertion compared with patients in the control group with normal placental cord insertions. No difference in this proportion was found between normal PCI and marginal cord insertion (P=0.557).