Zachariassen Gitte, Juvonen Pekka
Sønderborg Sygehus, børneafdelingen, Odense Universitetshospital, børneafdelingen.
Ugeskr Laeger. 2002 Oct 14;164(42):4930-4.
The aim was to identify characteristics in infants suffering from dehydration caused by breast-feeding malnutrition over a period of 21 months in South Denmark.
Infants admitted to a regional Paediatric Clinical Department in a rural area with a population of 254,000 and approximately 3000 live births per year. The infants were admitted with the diagnosis of dehydration fever, jaundice and dehydration, hypernatraemic dehydration or malnutrition. The cases were reviewed retrospectively and the outcome measures were maternal age and parity, the gestational age of the infant, birth weight, per cent loss from birth weight, complaints at presentation, age on admission, temperature on admission, and levels of blood glucose and serum sodium.
Fifty-four newborn infants were identified. Thirty-five infants had a temperature between 37.6 and 39.7 degrees C on admission. Thirty-seven infants had lost between 8% and 23.3% of their birthweight. Twenty infants suffered from hypernatraemic dehydration, their serum-sodium levels were 147-159 mmol/l. Four infants with hypernatraemic dehydration had lost less than 8% of the birth weight. Ten infants were large for gestational age (LGA). Compared to a control group, there was an overrepresentation of LGA children in the study group (p = 0.003). Thirty-one of 50 mothers were primigravida (p = 0.002). Thirty-one of 54 mothers were 30 years old or older (p = 0.05). There was a positive correlation between weight loss and high serum sodium levels (p = 0.01).
We found that a rise in temperature can be a sign of neonatal dehydration and malnutrition in breast-fed infants. Hypernatraemic dehydration can occur even if the weight loss is less than 10% of the birth weight. Infants who are LGA can also develop neonatal dehydration.
目的是确定丹麦南部21个月期间因母乳喂养营养不良导致脱水的婴儿的特征。
婴儿被收治于一个农村地区的区域儿科临床科室，该地区人口为254,000，每年约有3000例活产。这些婴儿因脱水发热、黄疸与脱水、高钠血症性脱水或营养不良的诊断而入院。对病例进行回顾性分析，结果指标包括母亲年龄与胎次、婴儿的孕周、出生体重、出生体重减轻百分比、就诊时的症状、入院年龄、入院体温以及血糖和血清钠水平。
共确定了54例新生儿。35例婴儿入院时体温在37.6至39.7摄氏度之间。37例婴儿出生体重减轻了8%至23.3%。20例婴儿患有高钠血症性脱水，其血清钠水平为147 - 159 mmol/l。4例高钠血症性脱水婴儿出生体重减轻少于8%。10例婴儿为大于胎龄儿（LGA）。与对照组相比，研究组中LGA儿童比例过高（p = 0.003）。50位母亲中有31位为初产妇（p = 0.002）。54位母亲中有31位年龄在30岁及以上（p = 0.05）。体重减轻与高血清钠水平之间存在正相关（p = 0.01）。
我们发现体温升高可能是母乳喂养婴儿新生儿脱水和营养不良的一个迹象。即使体重减轻少于出生体重的10%，也可能发生高钠血症性脱水。LGA婴儿也可能发生新生儿脱水。
