366 - Sodium Supplementation and Hypertension in Preterm infants: A Retrospective Study

Poster Number: 366
Publication Number: 366.132

Daphney Clermont, SSM Cardinal Glennon Children's Medical Center, St. Louis, MO, United States; Noah Hillman, Saint Louis University School of Medicine, st. Louis, MO, United States; Howard Williams, SSM Cardinal Glennon Children's Medical Center, St. Louis, MO, United States; Rebecca Y. Petersen, Saint Louis University School of Medicine, St. Louis, MO, United States; Daphney Clermont, SSM Cardinal Glennon Children's Medical Center, St. Louis, MO, United States

Background: Compared with term infants, preterm infants have increased sodium requirements, largely due to immature kidneys. Sodium is a growth promoting factor necessary for optimal development after preterm birth, and enhanced weight gain by 20% in infants born < 28 weeks. While preterm birth and rapid weight gain are independent risk factors for neonatal hypertension (HTN), the effect of sodium supplementation on HTN in preterm infants has not been evaluated.

Objective: To determine if oral sodium supplementation is associated with HTN in preterm infants less than 32 weeks.

Design/Methods: This was a retrospective study of infants admitted to the SSM Health Cardinal Glennon Children's Hospital and the SSM Health St. Mary’s Hospital Neonatal Intensive Care Units from 12/01/2015-12/01/2020. Using the electronic medical record, we collected data for each subject as shown in table 1. Inclusion criteria included infants born 22-32 weeks and weighing 450-1500 grams. Exclusion criteria included infants with major congenital malformations deemed incompatible with life, chromosomal disorders, renal insufficiency, short gut, disease states characterized by edema (i.e. hydrops fetalis), and infants who did not survive beyond 7 days of life. We then determined the association between sodium supplementation and HTN in the entire cohort (Nf874) and in babies weighing less than 1000 grams (n=434).

Results: Infants receiving sodium supplementation were smaller and less mature (table 1). Fifty percent of infant < 32 weeks received sodium supplementation, and 76% of infants < 1000 g. Infants receiving sodium were more likely to have HTN in total cohort (27% vs 6%), and in infants less than 1000 grams (29% vs 9%). Unadjusted Odds of HTN with sodium supplementation were OR 5.6 (95% CI 3.6, 8.7) for total cohort and OR 4.5 (95% CI 2.2, 9.3) for infants < 1000 g.Conclusion(s): These findings suggest that sodium supplementation contributes to the development of HTN in preterm infants, with increasing odds with lower birth weights. Logistic regression with common neonatal morbidities are underway to determine the causative effect of sodium supplementation.
Daphney_CV_20220103.pdf