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Dysnatremia in extremely low birth weight infants is associated with multiple adverse outcomes

Christopher S Monnikendam1, Thornton S Mu2, James K Aden3

  • 1Department of Pediatrics, Naval Medical Center Portsmouth, Portsmouth, VA, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|April 2, 2019
PubMed

Insights

Serum sodium levels in extremely low birth weight (ELBW) infants are critical. Abnormal sodium levels (dysnatremias) in the first week of life significantly increase mortality risk in these vulnerable infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Clinical Chemistry

Background:

  • Extremely low birth weight (ELBW) infants are susceptible to electrolyte imbalances.
  • Serum sodium levels are crucial for neonatal health and outcomes.
  • Understanding sodium patterns in ELBW infants is vital for improving care.

Purpose of the Study:

  • To analyze serum sodium patterns in a large cohort of ELBW infants.
  • To determine the association between sodium levels and hospital outcomes.
  • To identify risks associated with hyponatremia and hypernatremia in ELBW infants.

Main Methods:

  • Retrospective cohort study of ELBW infants (2004-2014).
  • Included 12,428 infants surviving at least 7 days with daily sodium data.
  • Categorized infants based on minimum and maximum serum sodium levels.

Main Results:

  • Only 15.8% of ELBW infants maintained normal sodium (eunatremia) in the first week.
  • Dysnatremias were linked to higher mortality rates compared to eunatremia.
  • Moderate hyponatremia (12.9%) and severe hypernatremia (34.8%) showed increased mortality.

Conclusions:

  • Serum sodium fluctuations in the first week of life are associated with increased mortality in ELBW infants.
  • Maintaining eunatremia is crucial for survival in ELBW infants.
  • Early identification and management of dysnatremias may improve outcomes.
Abstract

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