Nuchal cord and neurodevelopmental performance at 1 year

Objective: To test the null hypothesis that the presence of a nuchal cord at delivery has no effect on neurodevelopmental performance at 1 year of age. Methods: The offspring of 190 women with clinically normal antenatal courses were evaluated within 1 month of their first birthday by a blinded observer using the Bayley Scales of Infant Development. The cases were grouped based on the presence of a symptomatic nuchal cord during labor (abnormal fetal heart rate patterns of meconium), and significant differences were detected using analysis of variance. Results: A symptomatic nuchal cord was present during labor and delivery in 24% of the 190 cass. At 1 year of age scores on both Bayley scales were slightly but significantly (P < .01) lower in the offspring delivered with a symptomatic nuchal cord. The mental index was 116 +/- 9 versus 120 +/- 7, and the psychomotor index was 101 +/- 11 versus 107 +/- 9. These differences were accentuated (P = .09) when the symptomatic cases without these additional complications (overall index 110 +/- 8 versus 105 +/- 10). There were no between group differences in multiple potential confounding obstetric of demographic variables. Conclusions: These data do no support the null hypothesis and suggest that symptomatic nuchal cords, which are identified before labor as being extremely tight of having multiple loops, may be associated with a subclinical deficit in neurodevelopmental performance at 1 year of age. Copyright (C) 1999 by the Society of Gynecologic Investigation.