“True knots arise from fetal movements and are more likely to develop during early pregnancy, when relatively more amniotic fluid is present and greater fetal movement occurs. True knots are also associated with advanced maternal age, multiparity, and long umbilical cords,” the site says.
As such, true knots can be dangerous.
“True knots have been reported to lead to a 4-fold increase in fetal loss, presumably because of compression of the cord vessels when the knot tightens,” the site says.
(H/T - IJReview)