{"title":"Effect of early sodium supplementation on weight gain of very preterm infants: a randomised controlled trial.","authors":"Anvesh Amiti, Umamaheswari Balakrishnan, Usha Devi, Prakash Amboiram, Abdul Gani Salahudeen","doi":"10.1136/bmjpo-2025-003444","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Preterm neonates are at risk of impaired growth. Hyponatraemia in preterm neonates is due to renal immaturity and can lead to growth failure. We aimed to assess the effect of early enteral sodium supplementation on weight gain velocity from birth to 34 weeks postmenstrual age in preterm neonates.</p><p><strong>Methods: </strong>In this double-blinded randomised controlled trial, we recruited neonates born between 25 weeks and 30 weeks+6 days of gestation who received a minimum feed volume of 100 mL/kg/day before 10 days of life. In the intervention group, 4 mEq/kg/day of oral sodium was administered using 15% saline and, in the control group, normal saline was given as a placebo. The primary outcome was mean weight gain velocity in g/kg/day.</p><p><strong>Results: </strong>A total of 104 neonates were recruited with 52 infants in each group. Mean (SD) weight gain velocity (g/kg/day) was significantly greater in intervention than in control group (18.0±4.4 vs 14.4±3.9; mean difference 3.6 with 95% CI 2.04 to 5.27, p<0.001). Linear growth (cm/week) was greater in intervention than in control group (0.88±0.18 vs 0.73±0.28 cm/week; mean difference 0.14 with 95% CI 0.05 to 0.24, p=0.04). Subgroup analysis in extreme preterm showed similar results. There was no significant difference in head growth or clinical outcomes between the groups.</p><p><strong>Conclusion: </strong>Early postnatal sodium supplementation improves in-hospital weight gain and linear growth in very preterm neonates.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258284/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Paediatrics Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjpo-2025-003444","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: Preterm neonates are at risk of impaired growth. Hyponatraemia in preterm neonates is due to renal immaturity and can lead to growth failure. We aimed to assess the effect of early enteral sodium supplementation on weight gain velocity from birth to 34 weeks postmenstrual age in preterm neonates.
Methods: In this double-blinded randomised controlled trial, we recruited neonates born between 25 weeks and 30 weeks+6 days of gestation who received a minimum feed volume of 100 mL/kg/day before 10 days of life. In the intervention group, 4 mEq/kg/day of oral sodium was administered using 15% saline and, in the control group, normal saline was given as a placebo. The primary outcome was mean weight gain velocity in g/kg/day.
Results: A total of 104 neonates were recruited with 52 infants in each group. Mean (SD) weight gain velocity (g/kg/day) was significantly greater in intervention than in control group (18.0±4.4 vs 14.4±3.9; mean difference 3.6 with 95% CI 2.04 to 5.27, p<0.001). Linear growth (cm/week) was greater in intervention than in control group (0.88±0.18 vs 0.73±0.28 cm/week; mean difference 0.14 with 95% CI 0.05 to 0.24, p=0.04). Subgroup analysis in extreme preterm showed similar results. There was no significant difference in head growth or clinical outcomes between the groups.
Conclusion: Early postnatal sodium supplementation improves in-hospital weight gain and linear growth in very preterm neonates.
背景和目的:早产儿存在发育障碍的风险。早产儿低钠血症是由于肾脏不成熟,可导致生长衰竭。我们的目的是评估早期肠内钠补充对早产儿从出生到经后34周体重增加速度的影响。方法:在这项双盲随机对照试验中,我们招募了出生在妊娠25周至30周+6天的新生儿,这些新生儿在出生10天之前接受了最低100 mL/kg/天的饲料量。在干预组中,给予4 mEq/kg/天的口服钠,并使用15%生理盐水;在对照组中,给予生理盐水作为安慰剂。主要终点为平均增重速度(g/kg/day)。结果:共招募新生儿104例,每组52例。干预组平均(SD)增重速度(g/kg/天)显著高于对照组(18.0±4.4 vs 14.4±3.9;结论:产后早期补充钠可改善极早产儿的住院体重增加和线性生长。