Central venous catheter use is associated with reduced growth velocity and delayed enteral feeding in very low birth weight infants

Introduction: Central venous catheters (CVCs) are widely used in preterm infants. They secure vascular access, but their value for nutrition and neonatal outcome remains uncertain. Methods: Within the German Neonatal Network (GNN) cohort, we evaluated data of very low birth weight infants (VLBWI) <29 weeks’ gestation with and without CVCs. Associations between CVC use, growth, enteral feeding advancement, and duration of hospitalization were assessed using univariate and multivariate regression models. A survey among all German tertiary level neonatal intensive care units additionally assessed nutrition practices. Results: Among 12,516 infants, 82% received CVCs. Infants with CVCs had a lower mean gestational age (26.28 vs. 27.46 weeks, p<0.001) and birth weight (821 vs. 1,002g, p<0.001) compared to those without CVCs. In adjusted analyses, CVC use was associated with reduced neonatal weight gain (β -0.219 [CI -0.424 to -0.015], p=0.036) and head growth (β -0.040 [-0.054 to -0.025], p<0.001), delayed full enteral feeding (β 4.446 [3.820 to 5.071], p<0.001), and prolonged hospitalization (β 0.412 [0.376 to 0.449], p<0.001). Conclusion: Within the limits of an observational design, CVC utilization was associated with reduced growth, delayed full enteral feeding, and prolonged hospitalization in VLBWI. While findings should be interpreted in the context of differences in immaturity and morbidity between groups, they may contribute to further evaluation of current nutritional strategies, including routine CVC use for early-life parenteral nutrition, as well as more individualized approaches to nutritional management and careful consideration of CVC indications in VLBWI.