Hypernatremic dehydration in the newborn period and long-term follow up

Hypernatremic dehydration due to inadequate fluid intake can be a significant problem during the neonatal period and thereafter. The objective of the present study was to evaluate the term newborn infants admitted to Gazi University Hospital neonatal intensive care unit (NICU) for hypernatremic dehydration between June 2001 and June 2003 and compare the results with those of the literature search performed via MEDLINE for infants with the same diagnosis.

Infants with weight loss > or =10% were evaluated for hypernatremia and the ones with serum Na level > or =150 mEq/L were admitted to NICU. Long-term follow-up evaluations were performed using Bayley Scales of Infant Development I (BSID I) and Bayley Infant Neurodevelopmental Screener (BINS) tests.

Between June 2001 and June 2003, 28 newborns were admitted to NICU with hypernatremic dehydration. Literature review found 178 newborns with the same diagnosis since 1979 and detailed information was available for 150 patients. In the study and MEDLINE groups, respectively mean days of admission were 3.39 and 11.7; mean serum sodium, 156.5 and 178.6 mEq/L; and mean % weight loss, 11.5 and 25.7. Long-term follow up was performed in 15 patients from the study group, and two patients were found to be severely neurologically delayed. Five patients were found to have moderate risk scores by BINS tests.

Early follow-up visits of newborns soon after discharge are important to determine risk for hypernatremic dehydration. Long-term follow up of this group of babies is also required to gather knowledge about the repercussions of early hypernatremic dehydration later in life.