AUTHOR=Liang Chunyan , Liu Jinming , Tang Yingzi , Zhao Wenpiao , Xin Ruining , Gu Xiaoqun , Huang Fang , Lai Yu'e , Huang Wangjin , Liu Yanhong , Lin Mei , Pan Lili , Cao Guirong , Tan Sudan , Wei Chunliu , Lin Fangyuan 

TITLE=Risk factors for peripherally inserted central catheter malposition in preterm infants: a multicenter retrospective study

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2025.1534799

DOI=10.3389/fped.2025.1534799

ISSN=2296-2360

ABSTRACT=ObjectiveTo explore the risk factors affecting peripherally inserted central catheter (PICC) tip malposition in preterm infants.MethodsA retrospective collection of clinical data from preterm infants who underwent PICC placement in the neonatal departments of Guangxi Maternal and Child Health Hospital and eight other hospitals from January 2021 to April 2024 was conducted. The incidence of catheter tip malposition was analyzed. The infants were divided into two groups based on the occurrence of catheter tip malposition: the malposition group and the non-malposition group. Multifactorial logistic regression and multimodel logistic regression analyses were employed to explore the influencing factors of PICC tip malposition in preterm infants.ResultsA total of 1,449 infants were ultimately included in the study, with an incidence of catheter tip displacement of 12.56% (182 out of 1,449). Adjusted results from multimodel regression analysis of covariates indicated that Sample selection location in Guilin (OR = 2.30, 95% CI:1.24∼4.25), Yulin (OR = 4.35, 95% CI: 2.27∼8.34) and Qinzhou (OR = 2.63, 95% CI:1.37∼5.08), duration of catheter insertion procedure (OR = 1.01, 95% CI: 1.01∼1.02), duration of catheter dwell (OR = 1.04, 95% CI: 1.02∼1.07), weight percentile at the time of catheter malpositioning (OR = 11.39, 95% CI:4.81∼26.95), extremely preterm group (<28 weeks gestation) (OR = 4.42, 95% CI: 1.29∼15.16) were risk factors for catheter tip displacement. Additionally, site of PICC catheterization in neck as a risk factor (OR = 3.48, 95% CI: 1.89∼6.40).ConclusionSample selection location in Guilin, Yulin and Qinzhou, duration of catheter insertion procedure, duration of catheter dwell, weight percentile at catheter removal, extremely preterm group (<28 weeks gestation) and site of PICC catheterization in neck may increase the risk of PICC catheter tip malposition.