Amiti Anvesh, Balakrishnan Umamaheswari, Devi Usha, Amboiram Prakash, Salahudeen Abdul Gani
Neonatology, Sri Ramachandra Medical College and Research Institute, Chennai, India.
Neonatology, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India.
BMJ Paediatr Open. 2025 Jul 13;9(1):e003444. doi: 10.1136/bmjpo-2025-003444.
Preterm neonates are at risk of impaired growth. Hyponatraemia in preterm neonates is due to renal immaturity and can lead to growth failure. We aimed to assess the effect of early enteral sodium supplementation on weight gain velocity from birth to 34 weeks postmenstrual age in preterm neonates.
In this double-blinded randomised controlled trial, we recruited neonates born between 25 weeks and 30 weeks+6 days of gestation who received a minimum feed volume of 100 mL/kg/day before 10 days of life. In the intervention group, 4 mEq/kg/day of oral sodium was administered using 15% saline and, in the control group, normal saline was given as a placebo. The primary outcome was mean weight gain velocity in g/kg/day.
A total of 104 neonates were recruited with 52 infants in each group. Mean (SD) weight gain velocity (g/kg/day) was significantly greater in intervention than in control group (18.0±4.4 vs 14.4±3.9; mean difference 3.6 with 95% CI 2.04 to 5.27, p<0.001). Linear growth (cm/week) was greater in intervention than in control group (0.88±0.18 vs 0.73±0.28 cm/week; mean difference 0.14 with 95% CI 0.05 to 0.24, p=0.04). Subgroup analysis in extreme preterm showed similar results. There was no significant difference in head growth or clinical outcomes between the groups.
Early postnatal sodium supplementation improves in-hospital weight gain and linear growth in very preterm neonates.
早产新生儿存在生长发育受损的风险。早产新生儿低钠血症是由于肾脏不成熟所致，可导致生长发育迟缓。我们旨在评估早期肠内补充钠对早产新生儿从出生至孕龄34周时体重增加速度的影响。
在这项双盲随机对照试验中，我们招募了孕25周零天至30周+6天出生的新生儿，这些新生儿在出生后10天内接受的最低喂养量为100 mL/kg/天。干预组使用15%盐水口服补充4 mEq/kg/天的钠，对照组给予生理盐水作为安慰剂。主要结局是每天每千克体重的平均体重增加速度（单位：克）。
共招募了104名新生儿，每组52名婴儿。干预组每天每千克体重的平均（标准差）体重增加速度（单位：克）显著高于对照组（18.0±4.4 vs 14.4±3.9；平均差异为3.6，95%置信区间为2.04至5.27，p<0.001）。干预组的线性生长（厘米/周）大于对照组（0.88±0.18 vs 0.73±0.28厘米/周；平均差异为0.14，95%置信区间为0.05至0.24，p=0.04）。极早产儿的亚组分析显示了相似的结果。两组之间头围生长或临床结局无显著差异。
出生后早期补充钠可改善极早产新生儿在住院期间的体重增加和线性生长。
