Association between Umbilical Catheters and Neonatal Outcomes in Extremely Preterm Infants
28 May 2017
12 August 2017
14 September 2017 (eFirst)
Objective The objective of this study was to examine the association between umbilical catheters and a composite outcome of mortality or major neonatal morbidity in extremely preterm infants.
Study Design Data were abstracted from the Canadian Neonatal Network database for infants born at <29 weeks' gestational age and admitted to 29 neonatal intensive care units between January 2010 and December 2012. Four groups were identified: those with no umbilical catheters, umbilical venous catheters (UVCs), umbilical artery catheters (UACs), and those with both UVCs and UACs. The outcomes were compared among the groups using univariate and multivariable analyses.
Results Of 4,623 eligible infants, 820 (17.7%) had no catheters, 1,032 (22.3%) a UVC only, 120 (2.6%) a UAC only, and 2,651 (57.3%) had both catheters. After adjustment for acuity and other potential confounders, umbilical catheters were associated with higher odds of mortality or any major morbidity (UVC vs. no catheter: adjusted odds ratio [aOR]: 1.47; 95% CI: 1.18–1.85; UAC vs. no catheter: aOR: 1.67; 95% CI: 1.05–2.63; and both UVC + UAC vs. no catheter: aOR: 2.17; 95% CI: 1.79–2.70).
Conclusion Most of the infants born at <29 weeks' gestation had UVC and/or UAC placement. The presence of either catheter was associated with mortality or major morbidity, and the association was stronger when both catheters were present.
Keywordsumbilical catheters - extremely preterm infants - neonatal outcomes - mortality or any major morbidity - Canadian Neonatal Network
Mohamed S. Elboraee conceptualized the study, developed the data collection sheet, drafted the initial article, involved in data analysis, and approved the final article as submitted. Khalid Aziz, Jennifer Toye, and Prakesh S. Shah were involved in study design, data analysis, review of the article, and approved the final article as submitted. Xiang Y. Ye performed the statistical analyses, reviewed the article, and approved the final article as submitted. All authors approved the final article as submitted and agree to be accountable for all aspects of the work.
This work was supported by seed funding opportunity from the Department of Pediatrics, University of Alberta. Organizational support was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by grant funding from the Canadian Institutes of Health Research (FRN87518) and in kind support from Mount Sinai Hospital, Toronto, Ontario. Dr. Shah holds an applied research chair in Reproductive and Child Health Services and Policy Research awarded by the Canadian Institutes of Health Research (APR-126340).