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Background: The aim of study was to identify the asymptomatic hyparnatremia in exclusively breastfed neonates and to study the factors associated with it.Methods: A cross-sectional study was conducted from November 2010 to October 2012 in Jawaharlal Nehru Medical College and Hospital, A. M. U., Aligarh. Consecutive term appropriate-for-gestational age and asymptomatic neonates who were exclusively breastfed since birth were enrolled.Results: A total of 1360 term neonates were screened, out of which 145 neonates in each early and late neonatal group were enrolled. Prevalence of hypernatremia in 290 patients was 4.48% (n=13) with mean serum sodium level of 156.6'5.5 mmol/L, ranging from 151 to 167 mmol/L. It was 16 times more common in early compare to late neonates (adjusted odds ratio=16.074, P=0.001), 6 times more common in primi mothers (adjusted odds ratio=6.037, P=0.010) and 7 times more common during summer season (May-August) (adjusted odds ratio=6.566, P=0.017). Other variables like sex, mode of delivery and blood urea levels do not show significant association with hypernatremia. There was a significant positive correlation of serum sodium level with blood urea (r=0.123, P=0.037) and serum creatinine levels (r=0.157, P=0.007), and a negative correlation with blood sugar levels, but it was not significant (r=-0.072, P=0.224).Conclusions: The prevalence of hypernatremia in exclusively breastfed term asymptomatic neonates is 4.8%, and is more common in early neonatal period, in summer season and in babies born to primi mothers. There was a significant positive correlation of serum sodium with blood urea and creatinine levels.
RESUMEN
Objective To evaluate the significance of serum prealbumin, bilirubin/albumin( B/A )ratio and brainstem auditory evoked potential (BAEP)for early predicting the bilirubinic neurotoxicity caused by early neonatal hyperbilirubinemia. Methods According to the gestational age, birth weight and the intervention criterion of neonatal jaundice, 94 neonates (newborn infants with a age of 1-7days) with hyperbilirubinemia were divided into two groups, one was term neonates with normal BAEP, the other was term neonates with abnormal BAEP. We detected their serum levels of total bilirubine, prealbumin, BAEP and calculated B/A ratio. Result The prealbumin levels was significantly lower and B/A ratio was higher in group of abnormal BAEP than those of control group ( P < 0. 01 ), while the levels of total bilirubin were not significantly different between the two groups ( P > 0. 05 ). In group of abnormal BAEP , there was a negative correlation between the level of serum prealbumin and the B/A ratio (r = -0. 637, P <0. 01 ). Conclution Prealbumin may be a sensitive indicator for early predicting bilirubinic toxicity like B/A ratio and BAEP.