Postnatal maximal weight loss, fluid administration, and outcomes in extremely preterm newborns.

Autor: Valentine GC; Division of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, WA, USA. gcvalent@uw.edu.; Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine at Baylor College of Medicine, Houston, TX, USA. gcvalent@uw.edu., Perez KM; Division of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, WA, USA., Wood TR; Division of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, WA, USA., Mayock DE; Division of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, WA, USA., Comstock BA; Department of Biostatistics, University of Washington, Seattle, WA, USA., Puia-Dumitrescu M; Division of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, WA, USA., Heagerty PJ; Department of Biostatistics, University of Washington, Seattle, WA, USA., Juul SE; Division of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, WA, USA.; Center on Human Development and Disability, University of Washington, Seattle, WA, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2022 Aug; Vol. 42 (8), pp. 1008-1016. Date of Electronic Publication: 2022 Mar 25.
DOI: 10.1038/s41372-022-01369-7
Abstrakt: Objective: Evaluate maximal weight loss (MWL) and total fluid administration (TFA) association in first week after birth with outcomes among extremely preterm (EP) newborns.
Study Design: We performed a retrospective analysis of the Preterm Erythropoietin Neuroprotection Trial evaluating first-week MWL, TFA, and association with in-hospital outcomes.
Results: Among n = 883 included EP neonates, n = 842 survived ≥ 7 days and were included in outcome analyses. MWL between 5% to 15% was associated with decreased odds of necrotizing enterocolitis compared to MWL > 15% (OR 0.49, 95% CI 0.25-0.98). Average TFA > 150 mL/kg birthweight/day was associated with increased odds of necrotizing enterocolitis (OR 3.22, 95% CI 1.40-7.42) and patent ductus arteriosus requiring surgery (OR 2.14, 95% CI 1.10-4.15).
Conclusion: MWL between 5% to 15% is a potentially optimal window of MWL. Increasing average TFA in the first week is associated with adverse neonatal outcomes. Prospective studies evaluating MWL and TFA and relationship to outcomes in EP neonates are needed.
Clinical Trial Registration: This study is a secondary analysis of pre-existing data from the PENUT Trial Registration: NCT01378273, https://clinicaltrials.gov/ct2/show/NCT01378273 .
(© 2022. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
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