Nuchal cord is not associated with adverse perinatal outcome

Objective: The present study was aimed at evaluating the outcome of pregnancies with nuchal cord. Methods: A retrospective population-based study of all deliveries during the years 1988-2003 in a tertiary medical center was conducted. Immediate perinatal outcome of patients with and without nuchal cord was compared. Results: Of 166,318 deliveries during the study period, 14.7% had a nuchal cord, documented at birth (n = 24,392). Higher rates of labor induction and non-reassuring fetal heart rate patterns were noted among pregnancies with nuchal cord as compared with the control group (30.1% vs. 24.2%; OR = 1.3, 95% CI 1.3-1.4, P < 0.001 and 4.5% vs. 2.6%; OR = 1.8, 95% CI 1.6-1.9, P < 0.001; respectively). The cesarean delivery rate was significantly lower among pregnancies with nuchal cord (11.5% vs. 12.7%; OR = 0.9, 95% CI 0.8-0.9, P = 0.001). Although 1 min Apgar scores lower than 7 were more common in pregnancies with nuchal cord (4.8% vs. 4.4%; OR = 1.1, 95% CI 1.01-1.2, P = 0.008), these pregnancies actually had lower rates of 5 min Apgar scores less than 7 (0.5% vs. 0.7%; OR = 0.8, 95% CI 0.6-0.9, P = 0.004). Likewise, the perinatal mortality rate was significantly lower in pregnancies with nuchal cord as compared with the comparison group (11/1,000 vs. 16/1,000; OR = 0.7, 95% CI 0.6-0.8, P = 0.001). Conclusions: Nuchal cord is not associated with adverse perinatal outcome. Thus, labor induction in such cases is probably unnecessary.