Kloiber L L, Winn N J, Shaffer S G, Hassanein R S
Food and Nutrition Department, St Mary of the Plains Hospital, Lubbock, Tex 79410, USA.
J Am Diet Assoc. 1996 Sep;96(9):880-4. doi: 10.1016/s0002-8223(96)00240-4.
To determine the incidence of late hyponatremia in very-low-birth-weight infants and to identify associated risk factors. Low serum sodium concentration in otherwise healthy premature infants beyond 2 weeks of life is referred to as the hyponatremia.
Retrospective cohort review.
SETTING/SUBJECTS: The intensive care nursery at St Luke's Hospital Perinatal Center, Kansas City, Mo. Criteria for subject selection were birth weight of 1,500 g or less; survival for more than 21 days; development of late hyponatremia or hospitalization for 42 days or more; and measurement of serum sodium concentration at least once between the 14th and 56th day of life. Of 515 infants admitted to the nursery for the 1992 calendar year, 124 had a birth weight of 1,500 g or less and survived for more than 21 days; however, 16 of these infants were discharged at 42 days of life or less, 11 did not have a serum sodium concentration measurement after the second week of life, and 1 did not have complete medical records. Thus, the final sample was 96 subjects.
Percentages to determine incidence of late hyponatremia; t test of chi 2 test to determine differences between infants with and without late hyponatremia; multiple logistic regression to determine the strongest indicators of late hyponatremia.
Incidence of late hyponatremia was 62.5%. Significant risk factors for late hyponatremia were birth weight of 1,000 g or less (P < .001), feedings of fortified human milk (P < .013), and occurrence of an intraventricular hemorrhage (P < .036). Fortified human milk feeding was a significant risk factor for late hyponatremia in both weight groups (ie, birth weight greater than or less than 1,000 g).
Despite standard fortification, human milk may contain an insufficient quantity of sodium to met the needs of very-low-birth-weight infants.
确定极低出生体重儿晚期低钠血症的发生率，并识别相关危险因素。出生体重极低的健康早产儿在出生2周后血清钠浓度降低被称为低钠血症。
回顾性队列研究。
地点/研究对象：密苏里州堪萨斯城圣卢克医院围产期中心的重症监护病房。研究对象选择标准为：出生体重1500克或更低；存活超过21天；发生晚期低钠血症或住院42天或更长时间；在出生后第14天至第56天之间至少测量一次血清钠浓度。1992年全年入住该病房的515例婴儿中，124例出生体重1500克或更低且存活超过21天；然而，其中16例婴儿在出生42天或更早时出院，11例在出生后第二周后未进行血清钠浓度测量，1例没有完整的病历。因此，最终样本为96例研究对象。
计算晚期低钠血症的发生率；采用t检验或卡方检验确定有无晚期低钠血症婴儿之间的差异；采用多元逻辑回归分析确定晚期低钠血症的最强预测指标。
晚期低钠血症的发生率为62.5%。晚期低钠血症的显著危险因素包括出生体重1000克或更低（P < 0.001）、强化母乳喂养（P < 0.013）以及发生脑室内出血（P < 0.036）。强化母乳喂养是两个体重组（即出生体重大于或小于1000克）晚期低钠血症的显著危险因素。
尽管进行了标准强化，但母乳中钠含量可能不足以满足极低出生体重儿的需求。
