Risk Factors and Effects of Severe LateOnset Hyponatremia on Long-Term Growth of Prematurely Born Infants
	    		
		   		
		   			
		   		
	    	
    	 
    	10.5223/pghn.2020.23.5.472
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Ji Sook PARK
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Seul-Ah JEONG
			        		
			        		;
		        		
		        		
		        		
			        		Jae Young CHO
			        		
			        		;
		        		
		        		
		        		
			        		Ji-Hyun SEO
			        		
			        		;
		        		
		        		
		        		
			        		Jae Young LIM
			        		
			        		;
		        		
		        		
		        		
			        		Hyang Ok WOO
			        		
			        		;
		        		
		        		
		        		
			        		Hee-Shang YOUN
			        		
			        		;
		        		
		        		
		        		
			        		Chan-Hoo PARK
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Pediatrics, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
            
            
            	- From:Pediatric Gastroenterology, Hepatology & Nutrition
	            		
	            		 2020;23(5):472-483
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	 Purpose:Sodium is an essential nutritional electrolyte that affects growth. A low serum sodium concentration in healthy premature infants beyond 2 weeks of life is called lateonset hyponatremia (LOH). Here, we investigated the association between LOH severity and growth outcomes in premature infants. 
				        	
				        
				        	Methods:Medical records of premature infants born at ≤32 weeks of gestation were reviewed. LOH was defined as a serum sodium level <135 mEq/L regardless of sodium replacement after 14 days of life. Cases were divided into two groups, <130 mEq/L (severe) and ≥130 mEq/L (mild). Characteristics and growth parameters were compared between the two groups. 
				        	
				        
				        	Results:A total of 102 premature infants with LOH were included. Gestational age ([GA] 27.7 vs. 29.5 weeks, p<0.001) and birth weight (1.04 vs. 1.34 kg, p<0.001) were significantly lower in the severe group. GA was a risk factor of severe LOH (odds ratio [OR], 1.328, p=0.022), and severe LOH affected the development of bronchopulmonary dysplasia (OR, 2.950, p=0.039) and led to a poor developmental outcome (OR, 9.339, p=0.049). Growth parameters at birth were lower in the severe group, and a lower GA and sepsis negatively affected changes in growth for 3 years after adjustment for time. However, severe LOH was not related to growth changes in premature infants. 
				        	
				        
				        	Conclusion:Severe LOH influenced the development of bronchopulmonary dysplasia and developmental outcomes. However, LOH severity did not affect the growth of premature infants beyond the neonatal period.