Fluid regimens in the first week of life may increase risk of patent ductus arteriosus in extremely low birth weight infants.
BACKGROUND
High fluid volumes may increase neonatal morbidity. However, evidence supporting fluid restriction is inconclusive and restricting fluids may restrict caloric intake.


OBJECTIVE
To determine if higher fluid intake was associated with increased risk of patent ductus arteriosus (PDA) or bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants.


METHODS
A total of 204 ELBW (<or=32 weeks, <or=1250 g) infant survivors were grouped into low-, intermediate- and high-fluid groups. chi2 analyzed proportions of subjects with and without morbidities across groups. Logistic regression quantified increased risk of PDA or BPD associated with fluid intake while controlling for confounders. Analysis of variance compared differences in caloric intake across groups.


RESULTS
After controlling for gestational age, severity of illness and weight change, fluid intake on day 2 (odds ratio (OR) 1.014; confidence interval (CI) 1.001 to 1.028) and day 3 (OR 1.022; CI 1.004 to 1.040) was associated with increased risk of PDA.


CONCLUSIONS
High fluid intake (>170 ml kg(-1) day(-1)) in the first days of life is associated with increased risk of PDA.
Department of Pediatrics, Women and Infants' Hospital, Providence, RI, USA. bstephens@wihri.org
B E
BE
Stephens
R A
RA
Gargus
R V
RV
Walden
M
M
Mance
J
J
Nye
L
L
McKinley
R
R
Tucker
B R
BR
Vohr
D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology*; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D009752:Nutritional Status; D012189:Retrospective Studies; D012307:Risk Factors