Anne sütüyle beslenen yenidoğanlarda hipernatremik dehidratasyon
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Date
2013-09-01
Authors
Ergin, Hacer
Şahin, Özlem
Özmert, Melis Deniz
Özdemir, Muhammet Ali
Küçüktaşçı, Kazım
Hatipoğlu, Celile
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Giriş: Hayatı tehdit eden komplikasyonlara neden olabildiğinden, yenidoğanlarda yetersiz emzirmeye bağlı hipernatremik dehidratasyonun tanı ve tedavisi önemlidir. Gereç ve Yöntem: Çalışmada 2006-2012 yılları arasında sadece anne sütüyle beslenen ve hipernatremik dehidratasyon (serum Na≥150 mEq/L) saptanan 37-42 haftalık yenidoğanların dosyaları geriye dönük olarak incelendi. Bulgular: Hipernatremik dehidratasyon saptanan 26 yenidoğanın ortalama gebelik yaşı, doğum ağırlığı, ağırlık kaybı, anne yaşı ve tanı yaşı sırasıyla 38,8±1,1 hafta, 3292±458 gr, %13,5±5,5, 27,6±4,9 yaş ve 3,9±3,5 gündü. Kız cinsiyet, sezaryen doğum ve primipar anne oranları sırasıyla %57,6, %61,6 ve %57,6 idi. Başvuru şikâyetleri ateş (%30,7), emmede azalma ve sarılık (%26,9), huzursuzluk ve hipoaktivite (%7,6) idi. İlk beş gün içinde, yaz mevsiminde ve hastanede yatarken hipernatremik dehidratasyon sıklığı sırasıyla %84,6, %73 ve %42,3 idi. Ortalama BUN, kreatinin ve sodyum düzeyleri sırasıyla 45,6±64,1 mg/dl, 1,5±2,3mg/dl ve 157±11,9 mEq/L bulundu. Yirmialtı annenin %57,6’sı emzirme eğitimi almışken, %84,6’sı yeterli sıvı almamıştı. Konvülziyon saptanan dört hastanın birinde diyaliz gerektiren renal yetmezlik, üçünde prerenal böbrek yetmezliği ve birinde beyin ödemi gelişti. Serum sodyum düzeyleri primipar anne bebeği olan (p=0,002), dış merkezde doğan (p=0,012), anne yaşı küçük olan (p=0,035), emzirme eğitimi almayan (p=0,007) ve hastaneye geç başvuran bebeklerde (p<0,01) yüksek bulundu. Serum sodyum konsantrasyonunun ≥160 mEq/L olması komplikasyon ile ilişkiliydi (p<0,01). Anne yaşı azaldıkça (p=0,035) ve ağırlık kaybı arttıkça (p=0,016) serum sodyum düzeyi artmıştı. Sonuç: İlk hafta içerisinde ağırlık kaybının yakından izlemi ve başarılı emzirme teknikleriyle dehidratasyon bulgularının annelere öğretilmesi sayesinde yenidoğanlarda hipernatremik dehidratasyon önlenebilir.
Introduction: Since it can cause life-threatening complications in newborns, diagnosis and treatment of hypernatremic dehydration associated with inadequate breastfeeding is important. Materials and Methods: Records of exclusively-breastfed newborns (37-42 weeks) with hypernatremic dehydration (serum Na ≥150mEq/L) admitted between 2006 and 2012 were reviewed retrospectively. Results: The mean gestational age, birth weight, weight loss, maternal age, and age at diagnosis of 26 newborns with hypernatremic dehydration were 38.8±1.1 weeks, 3292±458 gr, 13.5±5.5%, 27.6±4.9 years, and 3.9±3.5 days, respectively. The percentages of female patients, caesarean delivery, and primipar mothers were 57.6%, 61.6%, and 57.6% respectively. Admission complaints were fever (30.7%), poor feeding and jaundice (26.9%), restlessness and hypoactivity (7.6%). Hypernatremic dehydration frequency within first five days, in summer season, during hospitalization were 84.6%, 73%, and 42.3%, respectively. The mean serum BUN, creatinine, Na levels were found 45.6±64.1 mg/dl, 1.5±2.3 mg/dl, and 157±11.9 mEq/L, respectively. Of 26 mothers, 57.6% had received breastfeeding education and 84% had inadequate fluid intake. Among four patients with seizures, three had prerenal failure, one had renal failure requiring dialysis, and brain edema developed in one. Serum Na levels were higher in infants who were baby of primipar mother (p=0.002), born in another hospital (p=0.012), from young mothers (p=0.035), from mothers with no breastfeeding education (p=0.007), and with delayed hospital admission (p<0.01). Serum Na concentrations ≥160mEq/L were associated with complications (p<0.01). Serum Na levels were negatively correlated with maternal age (p=0.035) and positively correlated with (p=0.016) weight loss. Conclusions: Hypernatremic dehydration can be prevented in newborns by close monitoring of weight loss and by teaching successful breastfeeding techniques and signs of dehydration to the mothers within first week.
Introduction: Since it can cause life-threatening complications in newborns, diagnosis and treatment of hypernatremic dehydration associated with inadequate breastfeeding is important. Materials and Methods: Records of exclusively-breastfed newborns (37-42 weeks) with hypernatremic dehydration (serum Na ≥150mEq/L) admitted between 2006 and 2012 were reviewed retrospectively. Results: The mean gestational age, birth weight, weight loss, maternal age, and age at diagnosis of 26 newborns with hypernatremic dehydration were 38.8±1.1 weeks, 3292±458 gr, 13.5±5.5%, 27.6±4.9 years, and 3.9±3.5 days, respectively. The percentages of female patients, caesarean delivery, and primipar mothers were 57.6%, 61.6%, and 57.6% respectively. Admission complaints were fever (30.7%), poor feeding and jaundice (26.9%), restlessness and hypoactivity (7.6%). Hypernatremic dehydration frequency within first five days, in summer season, during hospitalization were 84.6%, 73%, and 42.3%, respectively. The mean serum BUN, creatinine, Na levels were found 45.6±64.1 mg/dl, 1.5±2.3 mg/dl, and 157±11.9 mEq/L, respectively. Of 26 mothers, 57.6% had received breastfeeding education and 84% had inadequate fluid intake. Among four patients with seizures, three had prerenal failure, one had renal failure requiring dialysis, and brain edema developed in one. Serum Na levels were higher in infants who were baby of primipar mother (p=0.002), born in another hospital (p=0.012), from young mothers (p=0.035), from mothers with no breastfeeding education (p=0.007), and with delayed hospital admission (p<0.01). Serum Na concentrations ≥160mEq/L were associated with complications (p<0.01). Serum Na levels were negatively correlated with maternal age (p=0.035) and positively correlated with (p=0.016) weight loss. Conclusions: Hypernatremic dehydration can be prevented in newborns by close monitoring of weight loss and by teaching successful breastfeeding techniques and signs of dehydration to the mothers within first week.
Description
Keywords
Hipernatremi, Dehidratasyon, Yenidoğan, Hypernatremia, Dehydration, Newborn
Citation
Ergin, H. vd. (2013). "Anne sütüyle beslenen yenidoğanlarda hipernatremik dehidratasyon". Güncel Pediatri, 11(2), 51-56.