Introduction
Material and methods
Study design
Study setting and participants
Data sources
Exposures
Outcomes
Statistical analysis
Ethics
Results
Participants
P-Na < 135 mmol/l (n = 60) | P-Na ≥ 135 mmol/l (n = 28) | p value | |
---|---|---|---|
Severe NEC, n (%) | 43 (71.7) | 11 (39.3) | 0.005 |
Gestational age at birth (weeks), median (IQR) | 25.92 (24.85–28.86) | 26.35 (24.86–29.14) | 0.37 |
Birth weight (g), median (IQR) | 810 (678–1162) | 820 (702–1191) | 0.62 |
Male, n (%) | 45 (75) | 15 (53.6) | 0.05 |
SGA, n (%) | 14 (23.3) | 4 (14.3) | 0.40 |
Cesarean section, n (%) | 39 (65.0) | 18 (64.3) | 1.00 |
Any IVH, n (%) | 27 (45.0) | 9 (32.1) | 0.35 |
PDA, n (%) | 45 (75.0) | 22 (78.6) | 0.79 |
RDS, n (%) | 47 (78.33) | 22 (78.57) | 1.00 |
Post-natal age at NEC onset (days), mean (SD) | 15.3 (1.7) | 12.0 (2.1) | 0.253 |
Post menstrual age NEC onset (weeks), median (IQR) | 28.93 (26.7–31) | 28.07 (26.42–32.57) | 0.87 |
Pneumoperitoneum, n (%) | 20 (33.3) | 10 (35.7) | 0.82 |
Inotropes at NEC onset, n (%) | 4 (6.7) | 1 (3.6) | 1.00 |
P-Na before NEC onset (mmol/L) median (IQR) | 135 (133–138) | 139 (137–142) | 0.0001 |
Missing data, n (%) | 4 (6.7) | 1 (3.5) | |
P-Na at NEC onset (mmol/L), median (IQR) | 129 (127–132) | 137.5 (136–141.5) | 0.000 |
Na difference (mmol/L), median (IQR) | 5 (3–9.5) | 1 (2–3) | 0.000 |
Glucose at NEC onset (mmol/l), median (IQR) | 10.6 (7.6–14.5) | 9.4 (8.2–17.2) | 0.99 |
Missing data, n (%) | 14 (23.3) | 13 (46.4) | |
Lactate at NEC onset (mmol/l), median (IQR) | 2.3 (1.4–3.5) | 1.6 (1.1–2.5) | 0.04 |
Missing data, n (%) | 12 (20) | 9 (32.1) | |
Platelet count at NEC onset (10^9/L), median (IQR) | 104.5 (60–195) | 111 (64–187) | 0.81 |
Missing data, n (%) | 4 (6.7) | 2 (7.1) | |
Creatinine at NEC onset (µmol/L), median (IQR) | 64 (39–80) | 59.5 (43.5–69.5) | 0.66 |
Missing data, n (%) | 4 (6.7) | 4 (14.3) | |
CRP max during NEC episode (mg/L), median (IQR) | 115 (53.5–190) | 67.5 (31.5–187) | 0.44 |
Outcomes
Non-severe NEC (34) | Severe NEC (54) | p value | |
---|---|---|---|
Gestational age at birth (weeks), median (IQR) | 26.71 (25.29–29.14) | 25.86 (24.71–28.57) | 0.263 |
Age at NEC onset (days), mean (SD) | 18.74 (13.33) | 11.57 (11.53) | 0.009 |
Post-menstrual age at NEC onset (weeks), median (IQR) | 29.71 (28.14–32.42) | 28.07 (26–30.14) | 0.02 |
Pneumoperitoneum, n (%) | 0 (0) | 30 (55.56) | 0.000 |
P-Na before NEC onset (mmol/L) median (IQR) | 137 (134–139) | 136 (134–140) | 0.744 |
Missing data, n (%) | 1 (3) | 4 (7.4) | |
P-Na at NEC onset (mmol/L), median (IQR) | 134.5 (129–139) | 130 (128–134) | 0.016 |
P-Na < 135 mmol/L at NEC onset, n (%) | 17 (50.00) | 43 (79.63) | 0.005 |
ΔNa (mmol/L), median (IQR) | 3 (1–5) | 5 (2–9) | 0.003 |
Missing data, n (%) | 1 (3) | 4 (7.4) | |
Glucose at NEC onset (mmol/l), median (IQR) | 10 (7.4–13.7) | 10.7 (8.5–15.4) | 0.308 |
Missing data, n (%) | 15 (44) | 12 (22) | |
Lactate at NEC onset(mmol/l), median (IQR) | 1.5 (1–1.8) | 2.5 (1.7–4.2) | 0.0001 |
Missing data, n (%) | 9 (26.5) | 12 (22) | |
Platelet count at NEC onset (10^9/L), median (IQR) | 167 (90–299) | 82.5 (49–138.5) | 0.0014 |
Missing data, n (%) | 0 (0) | 6 (11.1) | |
Creatinine at NEC onset (µmol/L), median (IQR) | 48 (34–66) | 70 (48–81) | 0.01 |
Missing data, n (%) | 1 (3) | 7 (12.9) | |
CRP max during NEC episode (mg/L), median (IQR) | 115.5 (14–203) | 107 (58–181) | 0.523 |
Odds ratio (95% confidence interval) | p value | |
---|---|---|
Hyponatremia, CRUDE | 3.91 (1.52–10.04) | 0.005 |
Hyponatremia, adjusted for gestational age, post-natal age at NEC onset, creatinine value | 4.75 (1.69–13.6) | 0.004 |
Hyponatremia, excluding infants with pneumoperitoneum | 23.0 (2.78–190.08) | 0.004 |
ΔNa*, CRUDE | 1.19 (1.07–1.33) | 0.002 |
ΔNa*, adjusted for corrected gestational age and post-natal age at NEC onset | 1.21 (1.07–1.36) | 0.002 |
ΔNa*, excluding infants with pneumoperitoneum | 1.24 (1.06–1.43) | 0.004 |