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Maturational changes in sodium metabolism in periviable infants

Jeffrey L Segar1,2, Connie C Grobe3, Justin L Grobe4,5,6,7,8

  • 1Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, 999 North 92nd St, Suite C410, Milwaukee, WI, 53226, USA. jsegar@mcw.edu.

Pediatric Nephrology (Berlin, Germany)
|May 20, 2021
PubMed

Insights

Extremely preterm infants experience prolonged sodium loss and negative balance. Higher sodium intake than currently recommended is necessary for adequate growth in these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Pediatric Nephrology
  • Nutritional Science

Background:

  • Sodium depletion is linked to impaired somatic growth in infants.
  • Sodium requirements for extremely preterm (periviable) infants are not well-established.
  • Understanding early-life sodium homeostasis is critical for this population.

Purpose of the Study:

  • To investigate sodium homeostasis in extremely preterm infants during the first 10 weeks of life.
  • To determine the sodium requirements for achieving positive sodium balance and supporting growth.

Main Methods:

  • Longitudinal, observational study design.
  • Convenience cohort of 23 infants born at 22 0/7-23 6/7-week gestation.
  • Monitoring of sodium intake and urinary sodium excretion.

Main Results:

  • Urinary sodium loss remained high, averaging 7.7 mEq/kg/day at 2 weeks and 6.9 mEq/kg/day at 8 weeks.
  • Positive sodium balance was not achieved until 6 weeks of age.
  • A positive sodium balance associated with significant weight gain (30 g/day) was only observed at 10 weeks.

Conclusions:

  • Infants born at 22-23 weeks gestation exhibit prolonged high urinary sodium losses and negative sodium balance.
  • Current sodium intake recommendations may be insufficient for this population.
  • Increased sodium intake is required to achieve a significant positive sodium balance and support optimal growth.
Abstract

Keywords:
Fractional excretionHyponatremiaInfantPrematureSodium

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