Hipernatremia neonatal: factores de riesgo

Abstract

Introduction: Neonatal hypernatremic dehydration is a very common problem and now frequently described in the literature. Objectives: To establish risk factors associated with hypernatremic dehydration. Design: Retrospective, descriptive and analytical case control study. Place: Neonatal ward of the Hospital del Nio "Ovidio Aliaga Ura". La Paz. Bolivia. Methods: 64 newborns admitted with dehydration. Case control study, from February 2008 to January 2009. We defi ned cases to neonates with hypernatremic dehydration and controls, neonates with hyponatremic or isonatremic dehydration. The variable of the study were: maternal age, age of the neonate, percentage of weight loss and mother-son days in the hospital, information to mother before discharge, socio economic status, serum sodium and bilirubin levels, and cranial ultrasound study. Results: Of 70 neonates, six were excluded because they were immediately transferred to intensive care, of the 64 patients, 31 had hypernatremic dehydration and 33 isonatremic or hyponatremic dehydration. The most important risk factors for hypernatremic dehydration were: more than 10% weight loss, no maternal information about the correct breast feeding technique, early discharge and the association with jaundice. The loss of 10% or more of the newborn weight increases 47 more times the risk of developing hypernatremic dehydration. Conclusions: Hypernatremic dehydration is common in neonates with more tan 10% weight loss, usually secondary to breast feeding diffi culties, poor mother information about the correct breast feeding technique, early discharge and lack of follow up. We need to improve and correct these problems.