A hospital-based study on the burden of hyponatraemia, risk factors and outcomes in neonates admitted to intensive care unit

Abstract

Background: Hyponatraemia occurs frequently in newborns admitted to the neonatal intensive care unit (NICU). Methods: In this cross-sectional study, risk factors and outcomes (with respect to survival/neurological sequelae) of hyponatremia in neonates admitted to NICU. Results: In this study 384 neonates were studied, of which 324 neonates were admitted on day 1 of life, while 60 were transferred subsequently into NICU when indicated. Hyponatraemia was observed in 154 (36.9%) and hypernatraemia in 16 (3.8%) neonates. Logistic regression showed that pre-maturity (adjusted odds ratio [aOR] = 1.918, P = 0.005) and Apgar score <7 at 5 min (aOR = 2.867, P = 0.001) were statistically significant risk factors for the development of hyponatraemia. One hndred and forty seven neonates died; 17 were discharged against medical advice (DAMA). Hyponatraemia was present in 41.5% of neonates who died compared to 38.6% who survived (P = 0.82). Neurological abnormality was seen in 13/220 neonates who had survived and were followed-up for outcomes. Of these, 6 had hyponatraemia and 1 had hypernatraemia. Conclusions: Hyponatraemia is common in sick newborns in NICU. Pre-maturity and Apgar score <7 at 5 min are significant risk factors for hyponatraemia.

Keywords

• hypernatraemia
• hyponatraemia
• serum sodium
• sick neonates