The late hyponatremia in premature neonates and its short term outcome

Abstract

Preterm labour and prematurity of the neonate is one of the major health problems and is one of the most common causes of neonatal death. One of the complications of premature infants is hyponatremia. The effect of hyponatremia on the prognosis of preterm infants has not been well studied but according to the information available, growth restriction has been reported in animal and human samples. Therefore, in this study, we aim to examine preterm neonates with late hyponatremia, identify the risk factors, and evaluate the prognosis of these neonates. Materials and Methods: This Cross Secyional study was performed on preterm infants (less than 34 weeks) who were admitted to Alzahra 's Hospital in Tabriz with a diagnosis of hyponatremia after the second week or were diagnosed with hyponatremia during hospitalization. Samples were collected during one year (1398) and neonates were evaluated for risk factors and its short term prognosis. Results: A total of 186 neonates were studied. The gestational age of the neonates was 30 weeks (first and third quarters = 29-32). The sex of these infants was often male (54.3%). The type of delivery was cesarean section in most cases (60.7%). The type of feeding was often breast milk (68.1%). Late hyponatremia was occured in 50 infants (26.8%) in this study. Gestational age was significantly lower in the group with late hyponatremia than the control group (P = 0.001). However, there was no significant difference between the two groups in terms of sex distribution. Birth weight in the hyponatremia group was significantly lower than the control group (P = 0.001). Multivariate analysis with control of confounding factors only low birth weight and higher dose of prenatal steroid as well as the absence of AGA status in the fetus each independently predict the incidence of late hyponatremia in preterm infants. Regarding the prognosis of patients with late hyponatremia in preterm infants, the results showed that the presence of late hyponatremia in preterm infants was significantly associated with osteopenia, so that the presence of hyponatremia increases the risk of osteopenia by up to 2 times. Regarding the prognosis of patients with prolonged hyponatremia (more than 7 days) compared with short-term hyponatremia with or without hyponatremia in preterm infants, the results showed that the presence of prolonged late hyponatremia in preterm infants with BPD, osteopenia, ROP and retinop Laser had a significant relationship. However, no significant association was found between the presence of prolonged late hyponatremia in preterm infants with PVL, retinopathy for injection, length of hospital stay and mortality.