Hypernatremic Dehydration Risk Factors in Newborns: Prospective Case-Controlled Study

Abstract

Background The prevalence of hypernatremic dehydration (HND) has increased in recent years most likely due to insufficient intake of breast milk as the most important factor. This study aimed to investigate risk factors of HND.

Methods In this study, 47 neonates whom were diagnosed to have HND were included in the study group and 96 healty neonates whom were included in the control group. While demographic data of the patients were recorded, mothers were asked to fill out the sociodemographic/ psychosocial data form, Edinburgh Postpartum Depression Scale(EPDS) and STAI I and II State and Trait Anxiety Scale. Breast milk sodium concentrations were studied from mothers of all infants. The relationship between the development of neonatal HND and risk factors affecting this condition were evaluated.

Results Being the first-born baby of the family was found to be a significant risk factor for HND. Breast milk sodium concentration was 25.8±7.9 mmol/L in the HND group which was significantly higher than the control group. Median depression score was similar in both groups and there was no statistical difference in terms of groups. The anxiety score was higher in the control group compared to the study group. There was no difference in terms of other sociodemographic / psychosocial data of mothers.

Conclusion Primiparity or insufficient breastfeeding may result in elevated breast milk sodium levels and related neonatal HND. Breastfeeding support should principally target primiparous women to improve breastfeeding outcomes like as especially HND.

Zusammenfassung

Hintergrund und Ziel Der in den letzten Jahren beobachtete Anstieg der Prävalenz der hypernatriämischen (hypertonen) Dehydration (HND) ist am ehesten auf eine unzureichende Aufnahme von Muttermilch als Hauptrisikofaktor zurückzuführen. Ziel der Studie war es, Risikofaktoren für HND zu untersuchen.

Methoden In der vorliegenden Studie wurden 47 Neugeborene mit nachgewiesener HND in die Untersuchungsgruppe und 96 gesunde Neugeborene in die Kontrollgruppe aufgenommen. Im Rahmen der Aufnahme der demografischen Daten der Patientinnen wurden die Mütter gebeten, den Bogen für soziodemografische/psychosoziale Daten, die Edinburgh Postnatal Depression Scale (EPDS) und die Skalen STAI I und II des State and Trait Anxiety Inventory (STAI) auszufüllen. Die Natriumkonzentration in der Muttermilch wurde bei allen teilnehmenden Müttern bestimmt. Die Beziehung zwischen der Entwicklung eines HND beim Neugeborenen und den Risikofaktoren für das Auftreten dieses Krankheitsbilds wurde untersucht.

Ergebnisse Wenn das Neugeborene das erste Kind der Familie war, stellte dies einen wichtigen Risikofaktor für HND dar. Die Natriumkonzentration in der Muttermilch lag mit 25,8 ± 7,9 mmol/L in der HND-Gruppe signifikant über dem Wert in der Kontrollgruppe. Der mediane Depressions-Score war vergleichbar in beiden Gruppen und es fand sich kein statistisch signifikanter Unterschied. Der Angst-Score war in der Kontrollgruppe gegenüber der Untersuchungsgruppe erhöht. Bei den soziodemografischen/psychosozialen Daten der Mütter wurden keine Unterschiede gefunden.

Schlussfolgerung Bei Primipara oder unzureichendem Stillen können eine erhöhte Natriumkonzentration in der Muttermilch und eine dadurch bedingte HND beim Neugeborenen auftreten. Stillberatung sollte sich prinzipiell an Erstgebärende wenden, um das Stillergebnis insbesondere in Hinblick auf HND zu verbessern.

Keywords

Primiparity - Breastfeeding - Hypernatremic dehydration - Newborn

Schlüsselwörter

Primiparität - Stillen - Hypernaträmische Dehydration - Neugeborenes

Publikationsverlauf

Artikel online veröffentlicht:
21. Juli 2021

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