The objective was to evaluate the frequency and to identify risk factors associated with anomalies of cord and perinatal outcomes. Materials and methods: A retrospective case-control was performed from July2003 to December2015, involving all women with singleton pregnancies attended at Virgen de las Nieves University Hospital, Granada, Spain. We compared patients with true umbilical cord knot (TUCK), velamentous cord insertion (VCI), cord around the neck (CAN)against patients with a normal umbilical cord(NUC).The register includes all births fetuses over 24weeks gestation or with a weight greater than 500g.Patients with twin pregnancy, known fetal or chromosomal anomalies and those with other pathologies different from funicular were excluded from the study. We evaluated the following clinical characteristics: maternal age, gestational age, parity, neonatal sex, pre-existing or gestational hypertension, mode of onset (spontaneous, labor induction and elective cesarean) and ending mode (spontaneous, cesarean and instrumental). In the case of instrumental or cesarean delivery we registered the reason in a new variable called the non-reassuring fetal heart rate(NRFHR).The neonatal variables included were fetal sex, birth weight, meconium, Apgar score, umbilical cord pH and admission to the neonatal intensive care unit(NICU).To compare numerical variables we used the Student´s t -test, and to compare qualitative variables we used the Chi squaretest. Values of p<0.05 were considered significant. Result: The final study sample included of 31,877deliveries, which resulted in the birth of 272(0.9%) with TUCK, 29(0.1%) with (VCI),5212(16.4%) with (CAN) and 26,118(81.9%)with NUC.The cord anomalies were significantly more frequently multiparous (15.2%vs18.2;p<0.05), and there was a higher proportion of male infants (18.9%vs15.9%;p≤0.0 )compared with the control group. Emergency cesarean were more common in the cords anomalies (19.7%vs11.6%,p<0.05). All other pregnancy and delivery characteristics were similar for women in the study and control groups. Conclusion: The cord anomalies are relatively common and it is associated with increased incidence of emergency cesarean for non-reassuring fetal heart rate. During birth, however, it´s clinical significance seems to be minor. At present, little-if anything-can be done to prevent fetal death ascribable to cord anomalies because diagnosis using ultrasonography is challenging; however, the risk of death is still small. [ABSTRACT FROM AUTHOR]