Abstract：
BACKGROUND: Neonatal portal vein thrombosis (PVT) is frequently related to umbilical venous catheterization (UVC), but risk factors remain unclear. This study aims to analyze the variables associated to PVT in near- to full-term newborns with UVC, with a focus on newborns exposed to controlled therapeutic hypothermia (CTH) for hypoxic ischemic encephalopathy (HIE).
METHODS: This is retrospective cohort study of infants delivered at or after 36 weeks and with a birthweight over 1,500 g. All infants were assessed for UVC location and PVT using ultrasonography performed between day 5 and day 10 after catheterization.
RESULTS: Among 213 eligible patients, PVT was diagnosed in 57 (27%); among them, 54 (95%) were localized in the left portal vein branch. With all significant factors in univariate analysis considered, higher gestational age at birth (adjusted OR 1.35; 95% CI: 1.12-1.64, p = 0.002) and duration of UVC placement (adjusted OR 1.36; 95% CI: 1.11-1.67, p = 0.004) were the main risk factors of PVT. Among 87 infants who were cooled for HIE, 31 (36%) had PVT compared to 26 (21%) in infants without CTH. Using a multivariate model including variables linked to treatment procedures only, an increased PVT incidence was statistically associated with UVC duration (adjusted OR 1.33; 95% CI: 1.08; 1.63, p = 0.01) and CTH (adjusted OR 1.94; 95% CI: 1.04-3.65, p = 0.04).
CONCLUSIONS: Left PVT was frequently observed in near- to full-term neonates with UVC. Among factors linked to treatment procedures, both duration of UVC and CTH exposure for HIE were found to be independent risk factors of PVT.
METHODS: This is retrospective cohort study of infants delivered at or after 36 weeks and with a birthweight over 1,500 g. All infants were assessed for UVC location and PVT using ultrasonography performed between day 5 and day 10 after catheterization.
RESULTS: Among 213 eligible patients, PVT was diagnosed in 57 (27%); among them, 54 (95%) were localized in the left portal vein branch. With all significant factors in univariate analysis considered, higher gestational age at birth (adjusted OR 1.35; 95% CI: 1.12-1.64, p = 0.002) and duration of UVC placement (adjusted OR 1.36; 95% CI: 1.11-1.67, p = 0.004) were the main risk factors of PVT. Among 87 infants who were cooled for HIE, 31 (36%) had PVT compared to 26 (21%) in infants without CTH. Using a multivariate model including variables linked to treatment procedures only, an increased PVT incidence was statistically associated with UVC duration (adjusted OR 1.33; 95% CI: 1.08; 1.63, p = 0.01) and CTH (adjusted OR 1.94; 95% CI: 1.04-3.65, p = 0.04).
CONCLUSIONS: Left PVT was frequently observed in near- to full-term neonates with UVC. Among factors linked to treatment procedures, both duration of UVC and CTH exposure for HIE were found to be independent risk factors of PVT.
摘要：
背景：新生儿门静脉血栓形成（PVT）通常与脐静脉置管（UVC）有关，但风险因素仍不清楚.本研究旨在分析与UVC近足月新生儿PVT相关的变量，重点是新生儿暴露于受控治疗性低温（CTH）的缺氧缺血性脑病（HIE）。
方法：这是一项回顾性队列研究，研究对象是出生体重超过1,500g且在36周时或之后分娩的婴儿。所有婴儿在导管插入术后第5天至第10天使用超声检查评估UVC位置和PVT。
结果：在213名符合条件的患者中，57例(27%)诊断为PVT；其中，54(95%)位于左门静脉分支。考虑到单变量分析中的所有重要因素，出生时胎龄较高(校正OR1.35;95%CI:1.12-1.64,p=0.002)和UVC放置时间(校正OR1.36;95%CI:1.11-1.67,p=0.004)是PVT的主要危险因素.在87名因HIE降温的婴儿中，31（36％）患有PVT，而没有CTH的婴儿为26（21％）。使用仅包括与治疗程序相关的变量的多变量模型，PVT发生率增加与UVC持续时间(校正OR1.33;95%CI:1.08;1.63,p=0.01)和CTH(校正OR1.94;95%CI:1.04~3.65,p=0.04)有统计学相关.
结论：在近期至足月UVC新生儿中经常观察到左PVT。在与治疗程序相关的因素中，发现HIE的UVC持续时间和CTH暴露是PVT的独立危险因素。
方法：这是一项回顾性队列研究，研究对象是出生体重超过1,500g且在36周时或之后分娩的婴儿。所有婴儿在导管插入术后第5天至第10天使用超声检查评估UVC位置和PVT。
结果：在213名符合条件的患者中，57例(27%)诊断为PVT；其中，54(95%)位于左门静脉分支。考虑到单变量分析中的所有重要因素，出生时胎龄较高(校正OR1.35;95%CI:1.12-1.64,p=0.002)和UVC放置时间(校正OR1.36;95%CI:1.11-1.67,p=0.004)是PVT的主要危险因素.在87名因HIE降温的婴儿中，31（36％）患有PVT，而没有CTH的婴儿为26（21％）。使用仅包括与治疗程序相关的变量的多变量模型，PVT发生率增加与UVC持续时间(校正OR1.33;95%CI:1.08;1.63,p=0.01)和CTH(校正OR1.94;95%CI:1.04~3.65,p=0.04)有统计学相关.
结论：在近期至足月UVC新生儿中经常观察到左PVT。在与治疗程序相关的因素中，发现HIE的UVC持续时间和CTH暴露是PVT的独立危险因素。
