1. Figure 1 365 cases 24 cases: neonatal or infant death
Normal cord insertion (270 cases)
Cerebral palsy % (12)
Developmental disorder % (18)
Marginal cord insertion (57 cases)
Cerebral palsy % (9)
Developmental disorder % (8)
Velamentous cord insertion (14 cases)
Cerebral palsy % (4)
Developmental disorder % (4)

2. % Figure 2 Cerebral palsy * * ＊: p<0.05 28.6 % 15.8 % 4.4 % Normal
Marginal
(n=52)
Velamentous
(n=14)

3. Developmental disorder%
Figure 3
Developmental disorder * *
＊: p<0.05
28.6 %
14.0 %
6.7 %
Normal
(n=270)
Marginal
(n=52)
Velamentous
(n=14)

4. Figure 4 % Impaired hearing ＊: p<0.05 * 7.1 % * 1.8 % 0 % Normal
Marginal
(n=52)
Velamentous
(n=14)

5. Small for gestational age short statue
Figure 5 %
Small for gestational age short statue
28.6 %
21.1 %
15.2 %
Normal
(n=270)
Marginal
(n=52)
Velamentous
(n=14)

6. Table 1: Demographics of the subjects stratified according to the type of umbilical/placental cord insertion
Cord insertion
Normal　(n=288)
Marginal (n=63)
Velamentous (n=14)
Maternal
Age at delivery (year)
33.1 ± 5.0
33.1 ± 5.6
33.8 ± 4.9
Height (cm)
157.4 ± 5.4
157.3 ± 5.6
158.9 ± 3.7
Gestational weeks at delivery
30 ± 3 31
Gravida
1 (0-7)
0 (0-6)
1 (0-6)
Parity
0 (0-4)
0 (0-3)
0 (0-1)
Multiparous
35.8% (103)
44.4 %　(28)
35.7 % (5)
In vitro fertilization
16.0 (46)
15.9 % (10)
28.6 % (4)
Pregnancyinduced hypertension
48.3% (139)
38.1 % (24)
Cesarean section
99.3 % (286) *
93.7 % (59) *
100 % (14)
Fetal
Intrauterine growth arrest
27.1 % (78)
17.5 % (11)
21.4 % (3)
Steroid
54.5 % (157)
46.0 % (29)
64.3 % (9)
Neonatal
Birth weight (g)
873 ± 297
897 ± 299
939 ± 227
Birth weight (z-score)
-2.9 ± 0.7
-2.8 ± 0.6
-2.8 ± 0.7
Male
50.7% (146)
50.8% (32)
35.7% (5)
Apgar score 1 min.
6 (0-9)
6 (1-9)
Apgar score 5 min.
8 (1-10)*
7 (1-10)*
8 (3-9)
Umbilical arterial pH
7.268 ± 0.110
7.286 ± 0.103
7.262 ± 0.140
Base excess
-3.5 ± 4.5
-3.5 ± 4.4
-5.1 ± 6.2
Neonatal or infant death
6.3% (18)
9.5% (6)
0% (0)
Placenta and umbilical cord
Placental abruption
6.9% (20)
3.2 % (2)
7.1 % (1)
Placenta previa
0.3 % (1)
0 % (0)
Oligohydramnios
20.6 % (13)
Single umbilical artery
3.5 % (10) *
11.1 % (7) *
The data indicate the mean ± standard deviation, median (range) or frequency (n). Intrauterine growth arrest; estimated fetal body in ultrasound weight increased < 5% over two weeks.
Steroid; use of antenatal corticosteroids. Oligohydramnios; largest vertical diameter of any pocket ≦ 2 cm by ultrasound. * Significant difference (p<0.05) between two groups.

7. Table 2. Perinatal risk factors for cerebral palsy by univariate analysis
Cerebral palsy
(n=25)
non Cerebral palsy
(n=317)
Odds ratio
(95% Confidence interval)
Gestational weeks of delivery < 28weeks
16.0 % (4)
19.3 % (61)
0.80 ( )
Birth weight < 1000 g
84.0 % (21)
61.8 % (196)
3.24 ( )
Birth weight SD < -3
52.0 % (13)
32.5 % (103)
2.25 ( )
Placental weight < 200g
68.0 % (17)
36.6 % (116)
3.68 ( )
Velamentous cord insertion
3.2 % (10)
5.83 ( )
Marginal cord insertion
36.0 % (9)
15.2 % (48)
3.14 ( )
Single umbilical artery
4.0 % (1)
5.4 % (17)
0.77 ( )
Oligohydramnios
45.8 % (11)
23.9 % (74)
2.69 ( )
Cesarean section
100 % (25)
98.1 % (311)
0.98 ( )
Apgar Score 1 min <4
21.5 % (68)
0.70 ( )
Apgar Score 5 min <7
12.0 % (3)
17.4 % (55)
0.65 ( )
Umbilical arterial pH <7.1
1.9 % (6)
2.16 ( )
Umbilical arterial BE <-12
8.0 % (2)
6.3 % (20)
1.29 ( )
The data indicate frequency (n) and odds ratios were calculated by univariate analysis.

8. Table 3. Perinatal risk factors for developmental disorder by univariate analysis
developmental disorder
(n=30)
non-developmental disorder
(n=311)
Odds ratio
(95% Confidence interval)
Gestational weeks of delivery < 28weeks
40.0 % (12)
17.0 % (53)
3.25 ( )
Birth weight < 1000 g
90.0 % (27)
60.9 % (190)
5.78 ( )
Birth weight SD < -3
60.0 % (18)
31.4 % (98)
3.28 ( )
Placental weight < 200g
70.0 % (21)
35.9 % (112)
4.17 ( )
Velamentous cord insertion
13.3 % (4)
3.2 % (10)
4.63 ( )
Marginal cord insertion
26.7 % (8)
15.8 % (49)
1.94 ( )
Single umbilical artery
4.5 % (14)
3.26 ( )
Oligohydramnios
34.5 % (10)
24.7 % (75)
1.61 ( )
Cesarean section
93.3 % (28)
98.7 % (308)
0.18 ( )
Apgar Score 1 min <4
30.0 % (9)
20.2 % (63)
1.69 ( )
Apgar Score 5 min <7
16.0 % (50)
1.91 ( )
Umbilical arterial pH <7.1
10.0 % (3)
6.1 % (19)
1.71 ( )
Umbilical arterial BE <-12
The data indicate frequency (n) and odds ratios were calculated by univariate analysis.

9. Table 4: Results of the multivariate logistic regression analysis for neurological complications
Cerebral palsy
Adjusted odds ratio
(95% confidence interval)
p-value
Velamentous cord insertion
10.13 (2.53, 40.66)
0.001
Marginal cord insertion
8.52 (1.61, 11.36)
0.004
Developmental disorder
7.25 (1.81, 29.08)
0.005
Single umbilical artery
3.97 (1.05, 14.95)
0.042
Birth weight < 1000g
5.70 (1.15, 28.26)
0.033
Placental weight < 200g
2.82 (1.08, 7.36)
0.034
Data was analyzed by logistic regression analysis.