Randomised controlled trial of postnatal sodium supplementation on oxygen dependency and body weight in 25-30 week gestational age infants
Gary Hartnoll, Pierre Bétrémieux, Neena Modi
Section of
Paediatrics and Neonatal Medicine, Imperial
College School of Medicine, Hammersmith
Hospital, London W12 0NN
Correspondence to: Dr Neena Modi Email: nmodi{at}ic.ac.uk
Accepted 26 June 1999
AIM
To compare the
effects of early against delayed sodium supplementation on oxygen
dependency and body weight, in preterm infants of 25-30 weeks of
gestational age.
METHODSInfants were
stratified by gender and gestation and randomly assigned to receive a
sodium intake of 4 mmol/kg/day starting on either the second day after
birth or when weight loss of 6% of birthweight was achieved. Daily
sodium intake, serum sodium concentration, total fluid intake, energy
intake, clinical risk index for babies (CRIB) score and duration of
ventilatory support and additional oxygen therapy were recorded.
Infants were weighed daily. Weights at 36 weeks and six months of
postmenstrual age were also recorded.
RESULTSTwenty four
infants received early, and 22 delayed, sodium supplementation. There
were no significant differences in total fluid and energy intake
between the two groups. There was a significant difference in oxygen
requirement at the end of the first week, with 9% of the early group
in air in contrast to 35% of the delayed group (difference 26%, 95%
confidence interval 2, 50). At 28 days after birth the proportions were
18% of the early group and 40% of the delayed group (difference 22%,
95% CI 
5, 49). Proportional hazards modelling showed early sodium
supplementation and lower birthweight to be significantly associated
with increased risk of continuing oxygen requirement. The delayed
sodium group had a greater maximum weight loss (delayed 16.1%; early
11.4%, p=0.02), but there were no significant differences in time to
maximum weight loss, time to regain birthweight, and weight at 36 weeks
and 6 months of postmenstrual age.
CONCLUSIONIn infants
below 30 weeks of gestation, delaying sodium supplementation until at
least 6% of birthweight is lost has a beneficial effect on the risk of
continuing oxygen requirement and does not compromise growth.
Keywords: sodium intake; postnatal weight loss; chronic lung disease; growth
© 2000 by Archives of Disease in Childhood
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