Isolated Single Umbilical Artery as a Risk Factor for Urinary Tract Infections in Childhood

Nata Tifferet Willner, Tamar Wainstock, Asnat Walfisch, Eyal Sheiner, Daniella Landau, Ofer Beharier

Research output: Contribution to journalArticlepeer-review


Objective  This study aimed to determine whether isolated single umbilical artery (iSUA), even absent identifiable genitourinary (GU) abnormalities, increases the risk of GU infection during childhood. Study Design  Retrospective population-based comparison of fetuses with iSUA versus normal three-vessel cords. Fetuses with growth restriction, prematurity, multiple gestations, and anatomical or chromosomal anomalies were excluded. The primary outcome was hospital-associated GU infection during the first 18 years of life. Kaplan-Meier's survival curves were used to assess cumulative risk; Cox's multivariable models were used to adjust for confounders. Results  Among 227,599 term singleton deliveries, children with iSUA (n = 729) had a higher incidence (1.8 vs. 0.6%, p < 0.001) and cumulative incidence (log-rank test, p < 0.001) of hospital-associated GU infection. The Cox's models confirmed these findings (hazard ratio: >2.82, confidence interval: 1.63-4.87 in composite models). Conclusion  iSUA represents an independent risk factor for GU infection. Urinary tract imaging may be warranted.

Original languageEnglish
Pages (from-to)597-601
Number of pages5
JournalAmerican Journal of Perinatology
Issue number6
StatePublished - 1 May 2021


  • fetus
  • genitourinary infection
  • single umbilical artery
  • umbilical vessel
  • urinary tract infection

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology


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