Risk Factors and Neurological Outcomes of Neonatal Hypernatremia

Background: Hypernatremia might lead to neurological and developmental disabilities. This study aimed to determine the frequency, risk factors, and one-year neurological prognosis of hypernatremia in newborns. The findings of the present study may assist the prevention of hypernatremia mortality and complications. Methods: This cross-sectional study was conducted on all neonates admitted to the neonatal ward and the Neonatal Intensive Care Unit (NICU) of Bahrami Children's Hospital, Tehran, Iran from September 2013 to September 2014. All the newborns, who were diagnosed with hypernatremia (serum sodium>150 mEq/L) were included in this study. The data were collected using a form, which included clinical symptoms and risk factors for neonatal hypernatremia in addition to the laboratory data. Additionally, the patients were subjected to the developmental examination for one year. Another form was used during the follow-up period to collect all the relevant data. Results: A total of 1,923 newborns were examined in the present study. The results demonstrated that 74 (3.8) neonates had sodium levels of >150 mEq/L. Furthermore, jaundice was found to be the most prevalent presentation of hypernatremia, which was reported in 57 of the admitted neonates. Additionally, weight loss was the most common observation on the follow-up examinations. Neonates admitted at older ages (>7 days) had higher sodium levels (160.71±8.98 mEq/L). There were 18 neonates with seizures before or during the hospitalization and 19 (25.7) cases showed abnormal development during the one-year follow-up. Moreover, a statistically significant relationship was observed between the abnormal development and the presence of seizure (OR: 2.543, CI: 1.358-4.763). Conclusion: The findings of the current study demonstrated the critical role of weighing the newborns 72-96 h after birth and monitoring for jaundice in the prevention of the neonatal hypernatremia. Furthermore, seizures in these patients were associated with an increased risk of future developmental problems; however, more studies are required in this regard.

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