Predictors of Umbilical Venous Catheter Misalignment

Introduction: The insertion of an umbilical venous catheter (UVC) is a routine procedure. The success rate of this procedure is about 40-50%, with potential complications arising from misaligned UVC placement. Objectives: To explore potential factors that may aid in the prediction of UVC misalignment. We hypothesized that UVC misalignment is proportionally related with increased chronological age. Methods: Retrospective chart review for newborns who had an UVC procedure followed by an x-ray. All analyses were conducted using standard comparative statistical methods and logistic regression modelling with SPSS v.24 (IBM Corp., Armonk, NY, USA), and p-values < 0.05 were considered statistically significant. Results: The final sample size was 480 patients. There were significant differences between the two groups in terms of gestational age {OR 1.06, 95% CI (1.02-1.10)}, small for gestation (SGA) status {OR 1.07, 95% CI (0.98-1.15)}, and 5-min APGAR scores {OR 0.48, 95% CI (0.23-1.00)}. There were no other significant group differences. Logistic regression modeling identified that chronologic age positively predicted, and SGA negatively predicted, UVC misalignment. Conclusion: A misaligned UVC is more likely to occur in late preterm and term babies, whereas a baby being SGA increases the likelihood of a well-aligned UVC.