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Enteral water for hypernatremia and intestinal morbidity in infants less than or equal to 1000 g birth weight

Journal of Perinatology volume 27, pages 32–38 (2007)Cite this article

Abstract

Objective:

To evaluate the relationship between enteral water infusion for hypernatremia and significant intestinal morbidity in infants ⩽1000 grams.

Study design:

This is a retrospective study of 321 infants ⩽1000 g birth weight. Infants were grouped by the highest serum sodium (mmol/l) during the first 14 days of life as follows: <150 (normal control), ⩾150 (high sodium control), ⩾150 and treated with sterile water (study group). Significant intestinal morbidity was defined as probable or proven necrotizing enterocolitis or spontaneous intestinal perforation. Statistical analysis included Student's t test for continuous variables and χ2 with Yeats correction for frequency variables. Multivariate logistic regression analysis was then performed to evaluate confounding variables among groups.

Results:

The incidence of intestinal morbidity was significantly higher in the high sodium-water treated group compared to each of the other groups (13/33 (38%) for high sodium-water versus 16/100 (16%) for high sodium control and 18/188 (10%) for normal sodium control, P<0.01 χ2). Logistic regression analysis indicated that enteral water and hydrocortisone were risk factors for significant intestinal morbidity.

Conclusions:

Enteral sterile water for hypernatremia appears to be associated with significant intestinal morbidity in infants ⩽1000 g. Hydrocortisone is also a risk factor.

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Acknowledgements

We thank the physicians of Northwest Newborn Specialists PC and Kaiser Permenente of Oregon for allowing us to review medical records of their patients. We also acknowledge that the Vermont Oxford Data Base, of which both institutions are members, was most helpful in our review.

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Authors and Affiliations

  1. Legacy Emanuel Children's Hospital, Portland, OR, USA

    R K Huston, A M Dietz & N G Dolphin

  2. Providence St Vincent Medical Center, Portland, OR, USA

    B B Campbell & Y X Wu

  3. Kaiser Permanente of Oregon and Providence St Vincent Medical Center, Portland, OR, USA

    R S Sklar

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  1. R K Huston
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  2. A M Dietz
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  3. B B Campbell
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  4. N G Dolphin
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  5. R S Sklar
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  6. Y X Wu
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Correspondence to R K Huston.

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Huston, R., Dietz, A., Campbell, B. et al. Enteral water for hypernatremia and intestinal morbidity in infants less than or equal to 1000 g birth weight. J Perinatol 27, 32–38 (2007). https://doi.org/10.1038/sj.jp.7211622

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