Analysis of portal vein thrombosis prevalence and risk factors in neonates following umbilical venous catheterization: a systematic review and meta-analysis.

OBJECTIVES

To determine the prevalence of portal vein thrombosis (PVT) in neonates following umbilical venous catheterization (UVC), and to identify risk factors associated with PVT development in this population.

METHODS

Systematic review conducted in accordance with PRISMA guidelines. Prospective cohort studies assessing PVT in catheterized patients were included. Meta-analyses were performed using random-effects models for prevalence estimates and odds ratios (OR), heterogeneity assessment with Cochran's Q test and Higgins' I², and publication bias with funnel plot and Egger's test.

RESULTS

The search identified 344 studies, of which 11 met the inclusion criteria. The sample included 1086 neonates (1052 catheterized). Abdominal ultrasound confirmed 200 cases of PVT, yielding a prevalence of 19% (range: 0% to 49%), with six studies reporting prevalence rates above 5%. Meta-analysis showed an association between PVT and blood transfusion or exchange transfusion through the umbilical catheter (p = 0.0024). There was a trend toward increased risk of PVT in neonates with sepsis (p = 0.0705), whereas catheter tip location was not associated with increased PVT prevalence, although there is a risk of bias (p = 0.4636).

CONCLUSION

A wide variation in PVT prevalence was observed across the included studies. Blood transfusion through the umbilical catheter was confirmed as a risk factor, while neonatal sepsis was associated with a trend toward this outcome. These findings support the implementation of systematic abdominal ultrasound screening protocols for PVT in all neonates undergoing UVC.