Incorrect umbilical vein catheterization is associated with severe periventricular hemorrhages and mortality in extremely premature newborns.

Abstract

To investigate the relationship between umbilical vein catheter (UVC) placement and death in extremely premature newborns (<29 weeks gestation). Utilizing a retrospective, case-control study design, results for newborns that received UVC placements and died were compared with those who received UVC placements and survived (n = 719) by univariate and multiple logistic regression analyses. Death rate was 30% in infants with low lines versus 16% in those without (p = 0.012). High UVC tip placement significantly and independently increased severe periventricular hemorrhages (p = 0.014). Severe periventricular hemorrhage increased death rates by 3-fold independent of gestational age (p < 0.001). Proper line placement significantly reduced severe periventricular hemorrhage by 2.5-fold independent of gestational age (p = 0.019). In extremely premature newborns, incorrect UVC placement is significantly associated with death through its relation to severe periventricular hemorrhage.