Predictability of prognosis of infantile hypernatremic dehydration: a prospective cohort study

Abstract

Background

Infantile hypernatremic dehydration (IHD) is a life-threatening disease with potential cerebral adverse effects.

Purpose

This study was conducted to evaluate the prognosis of IHD.

Methods/Search strategy

Using convenience sampling 183 term infants with IHD (Na⁺ > 150 mg/dl) were enrolled in a cohort study with 36 months follow-up during 2007–2017. A researcher-made questionnaire was used for data collection. Follow-up visits were performed using the Denver Developmental Screening II test after discharging from hospital. The t-test, chi-square test, regression models, and receiver-operating characteristic curve were performed for data analysis.

Findings/results

17.5% of neonates were diagnosed with abnormal outcomes. Postpartum breast growth, breastfeeding frequency and duration, convulsion, consciousness, urination frequency, urea, Cr, sodium and brain CT scan (p = .000) showed significant differences (p < .05) between the infants with normal and abnormal outcomes. Combination of the above variables had a high predictive power (98.6%) for determining the unfavorable prognosis in infants with IHD.

Implications for practice

Sodium, urea and creatinine are high-sensitive/specific determinants of IHD prognosis. Combination of some risk factors is highly predictive for unfavorable prognosis of IHD.

Implications for research

Combination of variables such as sodium, urea, creatinine, lethargy, state of fontanels, convulsion, loss of consciousness, state of the breast during postpartum, inverted nipple and brain CT scan has a high predictive power in the determination of unfavorable prognosis in IHD.

Keywords:

• Infantile hypernatremic dehydration prediction
• prognosis

Author contributions

Hassan Boskabadi has conceptualized and designed the study, performed data acquisition, analysis and interpretation, and helped in manuscript drafting and critical revision. Maryam Zakerihamidi has helped in data analysis and interpretation as well as manuscript drafting. Ali Moradi has contributed to data analysis and interpretation, and performed manuscript drafting and critical revision.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the ethics committee of the Research Deputy of Mashhad University of Medical Sciences and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Ethics approval and consent to participate

A consent form was signed from parents of neonates after proper informing and prior to enrollment in the study.

Disclosure statement

All authors declare that they have no conflict of interest.

Competing interests

Health, Neonates, Reproductive health

Additional information

Funding

All phases of this study were supported and Funded by the Research Cluster, Mashhad University of Medical Sciences, grant number [87807-231187].