Somatic growth outcomes in response to an individualized neonatal sodium supplementation protocol

Elliot J Stalter; Silvia L Verhofste; John M Dagle; Emily J Steinbach; Patrick Ten Eyck; Linder Wendt; Jeffrey L Segar; Lyndsay A Harshman

doi:10.1038/s41372-024-02141-9

Somatic growth outcomes in response to an individualized neonatal sodium supplementation protocol

J Perinatol. 2024 Oct 17. doi: 10.1038/s41372-024-02141-9. Online ahead of print.

Authors

Elliot J Stalter¹, Silvia L Verhofste¹, John M Dagle¹, Emily J Steinbach¹, Patrick Ten Eyck², Linder Wendt², Jeffrey L Segar^#³, Lyndsay A Harshman^#^{4

5}

Affiliations

¹ Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa, IA, USA.
² Institute for Clinical and Translational Science, University of Iowa, Iowa, IA, USA.
³ Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
⁴ Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa, IA, USA. lyndsay-harshman@uiowa.edu.
⁵ Iowa Neuroscience Institute, University of Iowa, Iowa, IA, USA. lyndsay-harshman@uiowa.edu.

^# Contributed equally.

PMID: 39420073
DOI: 10.1038/s41372-024-02141-9

Abstract

Objective: Evaluate the impact of a sodium (Na) supplementation protocol based upon urine Na concentration on growth parameters and morbidities.

Study design: Retrospective cohort study of infants 26^0/7-33^6/7 weeks gestational age (GA) cared for before (2012-15, n = 310) and after (2016-20, n = 382) implementation of the protocol. Within- and between-group changes over time were assessed using repeated measures generalized linear models.

Results: For infants 26^0/7-29^6/7 weeks GA, utilization of the protocol was associated with increased mean body weight z-score at 8-weeks postnatal age, increased mean head circumference z-score at 16-weeks postnatal age, and decreased time on mechanical ventilation (all p < 0.02). No impact on growth was identified for infants 30-33^6/7 weeks GA. Incidences of hypertension, hypernatremia, bronchopulmonary dysplasia, necrotizing enterocolitis, and culture positive sepsis were unaffected by the protocol.

Conclusion: Protocolized Na supplementation is associated with improved growth and reduced time on invasive mechanical ventilation in extremely preterm infants without increasing incidence of morbidities.

Abstract

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