Rehospitalization for Neonatal Dehydration

Escobar, Gabriel J.; Gonzales, Veronica; Armstrong, Mary Anne; Folck, Bruce F.; Xiong, Blong; Newman, Thomas B.

doi:10.1001/archpedi.156.2.155

Cited by 87 publications

(67 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If weight controls are missing or are only performed sporadically, there is a danger of making the diagnosis too late, with the necessity for rehospitalisation and the risk of neurological, vascular and other complications [6,23,25]. In our study population, babies with severe hypertonic dehydration showed only a few, non-specific clinical features, such as hypotension and increased fatigue.…”

Section: Discussionmentioning

confidence: 85%

Prevention of hypernatraemic dehydration in breastfed newborn infants by daily weighing

2008

View full text Add to dashboard Cite

Hypernatraemic dehydration, which predominantly appears in breastfed neonates, can cause serious complications, such as convulsions, permanent brain damage and death, if recognised late. Weight loss ≥10% of birth weight could be an early indicator for this condition. In this prospective cohort study from October 2003 to June 2005 in the postnatal ward of the University Hospital Zurich, Switzerland, all term newborns with birth weight ≥2,500 g were weighed daily until discharge. When the weight loss was ≥10% of birth weight, serum sodium was measured from a heel prick. Infants with moderate hypernatraemia (serum sodium=146-149 mmol/l) were fed supplementary formula milk or maltodextrose 10%. Infants with severe hypernatraemia (serum sodium ≥150 mmol/l) were admitted to the neonatal unit and treated in the same way, with or without intravenous fluids, depending on the severity of the clinical signs of dehydration. A total of 2,788 breastfed healthy term newborns were enrolled. Sixty-seven (2.4%) newborns had a weight loss ≥10% of birth weight; 24 (36%) of these had moderate and 18 (27%) severe hypernatraemia. Infants born by caesarean section had a 3.4 times higher risk for hypernatraemia than those born vaginally. All newborns regained weight 24 h after additional fluids. Conclusion: In our study, one out of 66 healthy exclusively breastfed term neonates developed hypernatraemic dehydration. Daily weight monitoring and supplemental fluids in the presence of weight loss ≥10% of birth weight allows early detection and intervention, thereby preventing the severe sequellae of hypernatraemic dehydration.

show abstract

Section: Discussionmentioning

confidence: 85%

Prevention of hypernatraemic dehydration in breastfed newborn infants by daily weighing

2008

View full text Add to dashboard Cite

show abstract

“…We studied a cohort from the Northern California Kaiser Permanente Medical Care Program (KPMCP), a mature managed care organization with integrated information systems. (6,(16)(17)(18)(19)(20) Given the pathophysiology of dehydration, which does not appear to affect any one particular part of the brain, we did not expect to find discrete neurological deficits among our cohort. We expected to find non-specific neurodevelopmental problems affecting multiple domains (i.e., decreases in performance across multiple areas measured).…”

mentioning

confidence: 86%

“…We identified subjects born in 1995-96 in previous nested-case-control studies. (6,19,21) Study participants were drawn from 1995-98 KPMCP live births (N=106,627) with birth weights of at least 2000 grams and gestational age of at least 36 weeks (1995-96 cohorts) or 34 weeks (1997-98 cohorts). Eligible subjects had to meet the dehydration definition given below (cases) or were randomly selected from the 1995-96 and 1997-98 birth cohorts (controls) (Figure).…”

mentioning

confidence: 99%

Five-Year Neurodevelopmental Outcome of Neonatal Dehydration

Escobar¹,

Liljestrand²,

Hudes³

et al. 2007

The Journal of Pediatrics

Self Cite

View full text Add to dashboard Cite

Objective-To determine the long-term outcome of neonatal dehydration.Study design-We identified 182 newborns rehospitalized with dehydration (weight loss ≥12% of birth weight and/or serum sodium ≥150 mEq/L) and 419 randomly selected controls from a cohort of 106,627 term and near-term infants ≥2000 g born from 1995 through 1998 in Northern California Kaiser Permanente hospitals. Outcomes data were obtained from electronic records, interviews, questionnaire responses, and neurodevelopmental evaluations performed in a masked fashion.Results-Follow-up data to the age of at least two years were available for 173/182 children with a history of dehydration (95%) and 372/419 controls (89%) and included formal evaluation at a mean (±SD) age of 5.1±0.12 years for 106 children (58%) and 168 children (40%) respectively. None of the cases developed shock, gangrene, or respiratory failure. Neither crude nor adjusted scores on cognitive tests differed significantly between groups. There was no significant difference between groups in the proportion of children with abnormal neurologic examinations or neurologic diagnoses. Frequencies of parental concerns and reported behavior problems also were not significantly different in the two groups.Conclusions-Neonatal dehydration in this managed care setting was not associated with adverse neurodevelopmental outcomes in infants born at or near term. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. In this report, we focus on non-diarrheal neonatal dehydration. We studied a cohort from the Northern California Kaiser Permanente Medical Care Program (KPMCP), a mature managed care organization with integrated information systems. (6,(16)(17)(18)(19)(20) Given the pathophysiology of dehydration, which does not appear to affect any one particular part of the brain, we did not expect to find discrete neurological deficits among our cohort. We expected to find non-specific neurodevelopmental problems affecting multiple domains (i.e., decreases in performance across multiple areas measured). NIH Public Access METHODSThis report covers two of the three cohorts in the Jaundice and Infant Feeding ("JIFee") study, a follow-up study of infants with neonatal jaundice or dehydration and randomly selected controls. We identified subjects born in 1995-96 in previous nested-case-control studies. (6,19,21) Study participants were drawn from 1995-98 KPMCP live births (N=106,627) with birth weights of at least 2000 grams and gestational age of at least 36 weeks (1995-96 cohorts) or 34 weeks (1997-98 cohorts). Eligible subjects had to meet the dehydration d...

show abstract

“…4 Compared with term neonates, late preterm neonates are at higher risk for hospital readmissions, post-neonatal mortality, sudden infant death syndrome, white matter injury, and neuro-developmental problems well into the school age years. [5][6][7][8] Nitric oxide (NO) is the product of a fiveelectron oxidation of L-arginine mediated by one of three NO synthases: endothelial, neuronal, and inducible NO synthases (eNOS, nNOS and iNOS). 9 Neuronal NOS and eNOS are responsible for the continuous basal release of NO.…”

Section: Advances In Knowledgementioning

confidence: 99%

Nitric Oxide and Antioxidant Enzymes in Venous and Cord Blood of Late Preterm and Term Omani Mothers

Abiaka¹,

Machado²

2012

SQUMJ

View full text Add to dashboard Cite

This study assessed the role of oxidative stress in parturition in Omani mothers following growing reports that late preterm neonates were at greater risk than term neonates of perinatal death. Methods: Venous blood samples were collected during labour, and cord (neonatal) blood samples were taken after childbirth in late preterm and term from women at Sultan Qaboos University Hospital, Oman. Plasma nitric oxide (NO) concentrations, erythrocyte catalase (CAT). Erythrocyte glutathione peroxidase (GPx) activities were measured using spectrophotometric methods. Results: When compared with term mothers, late preterm mothers had markedly higher NO concentrations (µmol/L) 17.1 ± 3.3 versus 11.0 ± 5.5 (P <0.0001), and lower GPx values (U/g Hb) 94.1 ± 12.9 versus 110.4 ± 12.3 (P <0.0001). Late preterm mothers were significantly younger (P = 0.027) than term mothers and had neonates that weighed significantly less (P <0.0001) than term neonates. GPx activity was significantly reduced (P = 0.001) in late preterm neonates as compared to term neonates. CAT showed no change in activity in any comparison. Conclusion: Distinctly higher values of NO and lower GPx activity were found in late preterm mothers relative to term mothers; also, lower GPx in late preterm neonates relative to term neonates suggested a pro-oxidant-antioxidant imbalance due to the greater oxidative burden in late preterm parturition.

show abstract

Rehospitalization for Neonatal Dehydration

Abstract: In this population with good access to medical care, serious sequelae of neonatal dehydration are rare. Interventions to decrease the frequency of neonatal dehydration should focus on first-time mothers and those who breastfeed exclusively.

Cited by 87 publications

References 27 publications

Prevention of hypernatraemic dehydration in breastfed newborn infants by daily weighing

Prevention of hypernatraemic dehydration in breastfed newborn infants by daily weighing

Five-Year Neurodevelopmental Outcome of Neonatal Dehydration

Nitric Oxide and Antioxidant Enzymes in Venous and Cord Blood of Late Preterm and Term Omani Mothers

Contact Info

Product

Resources

About