Department of Child & Adolescent Health, Faculty of Medical Sciences, University of the West Indies, Mona, St. Andrew, Jamaica.
J Trop Pediatr. 2021 Jan 29;67(1). doi: 10.1093/tropej/fmaa083.
To determine the incidence, presentation and outcome of all neonates admitted to the University Hospital of the West Indies with a diagnosis of breastfeeding associated hypernatremic dehydration during a 15-year period and make comparisons with an earlier study done at the institution.
A retrospective review of the files of neonates admitted to the neonatal unit with breastfeeding associated hypernatremic dehydration between January 2002 and December 2016 was conducted. Data on maternal and neonatal demographics, presentation, laboratory results and outcome were extracted and descriptive analyses performed. Statistical significance was taken at the level p < 0.05.
Eighty neonates were entered into the study, 79 were inborn giving an incidence of 2.5 per 1000 live births. Fifty-five (71%) mothers were primiparous, with a mean ± SD age of 29.5 ± 5.6 years and mean ± SD length of hospital stay 2.6 ± 1.5 days. Fifty-six (71%) neonates were exclusively breastfed with a mean ± SD age at presentation of 5.6 ± 3.8 days, mean ± SD percentage weight loss of 16.3% ± 6.1% and a mean serum ± SD sodium of 156.1 ± 8.3 mmol/l. Fifty-four (68%) neonates were admitted from home and 22 (28%) from the postnatal ward. Complications seen included acute kidney injury 6 (8%), seizures 2 (3%), hypotonia 1 (1%) and bradycardia 1 (1%). The neonates were detected earlier, presented with a significantly lower mean serum sodium, urea and creatinine (p < 0.05), had less severe complications and no deaths compared with neonates in the previous study.
Early intervention can make a positive impact on the severity and complications of breastfeeding associated hypernatremia.
确定在 15 年期间，所有因母乳喂养相关性高钠血症脱水而被西印度群岛大学医院收治的新生儿的发病率、表现和结局，并与该机构早期的一项研究进行比较。
对 2002 年 1 月至 2016 年 12 月期间因母乳喂养相关性高钠血症脱水而被收入新生儿病房的新生儿的档案进行回顾性审查。提取了产妇和新生儿人口统计学、表现、实验室结果和结局的数据，并进行了描述性分析。统计学意义的水平设定为 p<0.05。
80 名新生儿被纳入研究，其中 79 名是经阴道分娩，发病率为每 1000 例活产 2.5 例。55 名（71%）母亲是初产妇，平均年龄±标准差为 29.5±5.6 岁，平均住院时间±标准差为 2.6±1.5 天。56 名（71%）新生儿完全母乳喂养，平均年龄±标准差为 5.6±3.8 天，平均体重下降率±标准差为 16.3%±6.1%，平均血清钠±标准差为 156.1±8.3mmol/L。54 名（68%）新生儿从家中入院，22 名（28%）从产后病房入院。并发症包括急性肾损伤 6 例（8%）、癫痫发作 2 例（3%）、低张力 1 例（1%）和心动过缓 1 例（1%）。与之前的研究相比，这些新生儿更早被发现，血清钠、尿素和肌酐的平均水平显著降低，并发症更轻，没有死亡。
早期干预可以对母乳喂养相关性高钠血症的严重程度和并发症产生积极影响。
