Hyponatraemia in very low birth weight XXXX .

@entity1 @entity1372
BACKGROUND: @entity1 less than 1500 grams at birth have been demonstrated to be particularly prone to development of low levels of serum @entity1372 often leading to increased early neonatal morbidity and mortality. No local study has been done to quantify this problem among sick newborns. Studies elsewhere demonstrate a high incidence of hyponatraemia among such preterms. OBJECTIVE: To evaluate the influence of @entity1 early neonatal morbidity on serum @entity1372 levels and justify regular monitoring and supplementation. DESIGN: Comparative cohort study. SETTING: Newborn Unit, Kenyatta National Hospital, Nairobi. SUBJECTS: Fifty six very low birth weight (1000-1500 grams at birth) @entity1 during their first week of life. Half of them were designated as cases in view of having various early neonatal illnesses. The remaining 28 being clinically stable were taken as controls. These two groups had comparable birthweights, sex distribution and gestational ages. Their @entity1372 intakes were also similar during the first week of life. RESULTS: The sick @entity1 (cases) had persistently low serum @entity1372 (mean of 120 mmols/L) throughout the first week while among the healthy @entity1 (controls) a sequential increase from 127 to 133 mmol/l, (mean values) was observed during the same period. The difference registered on day seven (133 versus 120) was statistically significant (p = 0.02). Using a cut off point of 130 mmol/L to define hyponatraemia the proportion of @entity1 with hyponatraemia, which was similar at the beginning became higher among the cases for the rest of the week with the largest disparity observed on the seventh day (75% versus 23%, p = 0.007). Urinary @entity1372 losses as measured by Fractional @entity1372 Excretion were also initially similar between the two groups but later became higher among the cases (4.96 versus 3.5 p=0.08). CONCLUSION: Very low birth weight @entity1 who are ill have lower serum @entity1372 and are more likely to develop significant hyponatraemia than their healthy counterparts during the first week of life. Standard care of these sick @entity1 must therefore routinely include regular monitoring of serum @entity1372 and its correction if found to be low.
