Risk Factors for Late-onset Hyponatremia and Its Influence on Neonatal Outcomes in Preterm Infants.
10.3346/jkms.2015.30.4.456
- Author:
Yoon Joo KIM
1
;
Jin A LEE
;
Sohee OH
;
Chang Won CHOI
;
Ee Kyung KIM
;
Han Suk KIM
;
Beyong Il KIM
;
Jung Hwan CHOI
Author Information
1. Department of Pediatrics, Jeju National University Hospital, Jeju, Korea.
- Publication Type:Original Article
- Keywords:
Hyponatremia;
Premature Infant;
Prematurity;
Risk Factors;
Outcome
- MeSH:
Bronchopulmonary Dysplasia/etiology;
Cohort Studies;
Female;
Humans;
Hyponatremia/*etiology;
Infant, Newborn;
Infant, Premature;
Logistic Models;
Male;
Retrospective Studies;
Risk Factors
- From:Journal of Korean Medical Science
2015;30(4):456-462
- CountryRepublic of Korea
- Language:English
-
Abstract:
Late-onset hyponatremia (LOH), hyponatremia occurring after two weeks of age with the achievement of full feeding, is the result of a negative sodium balance caused by inadequate salt intake or excessive salt loss due to immature renal or intestinal function in preterm infants. The aims of our study were to identify the risk factors for LOH and its influence on neonatal outcomes. This was a retrospective cohort analysis of 161 preterm infants born before 34 weeks of gestation between June 2009 and December 2010 at Seoul National University Hospital. LOH was defined as a sodium level < or = 132 mEq/L or 133-135 mEq/L with oral sodium supplementation. LOH occurred in 49 (30.4%) of the studied infants. A lower gestational age, a shorter duration of parenteral nutrition, the presence of respiratory distress syndrome, the use of furosemide, and feeding with breast milk were significant risk factors for LOH. In terms of neonatal outcomes, the infants with LOH had longer hospital stays and higher risks of bronchopulmonary dysplasia and retinopathy of prematurity requiring surgery. LOH lasting at least 7 days significantly increased moderate to severe bronchopulmonary dysplasia, periventricular leukomalacia, and extra-uterine growth retardation. LOH is commonly observed in preterm infants; it may be a risk factor for bronchopulmonary dysplasia and retinopathy of prematurity or a marker of illness severity.