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Petra Liljestrand, PhD1, Thomas B. Newman, MD2, Esther Hudes, PhD3, Rita Jeremy, PhD4, and Gabriel J. Escobar, MD1. (1) Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94611, 510-891-3476, petraL@itsa.ucsf.edu, (2) Dept of Epidemiology and Biostatistics, University of California, San Francisco, Box 0560, San Francisco, CA 94143, (3) Epidemiology & Biostatistics, University of California, Box 0886, 74 New Montgomery, San Francisco, CA 94105, (4) Pediatrics, University of California, Box 0105, San Francisco, CA 94143
Dehydration is a potentially serious condition for newborns and a common reason for readmission to the hospital. Risk factors include having a first-time mother, maternal age >=35 years, and being exclusively breast-fed. However, the long term outcomes of children without catastrophic neonatal courses are not known. We report on a study of 106 neonatal dehydration cases and 169 randomly selected controls from the Kaiser Permanente Medical Care Program (KPMCP) examined at age 5. Cases had been rehospitalized with >=12% weight loss and/or serum sodium >=150 mEq/L. Subjects were assessed with a neurological exam, standardized tests (WPPSI-R and VMI-4), and a motor checklist. Parents completed questionnaires about behavior (CBC-L) and development (PEDS), and covariables such as education, income, and maternal depression (CES-D). We used census tract data to compare SES of participants and nonparticipants.
Response rates were 59% for cases and 41% for controls. Case participants did not differ significantly from case nonparticipants. Control participants had higher average income (p=.03) & education (p=.04) in their census tracts and were more likely to have been initially breastfed (p=.03) than control nonparticipants. Cases and controls did not differ significantly on the neurological exam, the WPPSI-R verbal (mean scores: 102.2 and 101.7) or performance (mean score: 106.3 and 106.0) component, the three elements of the VMI, or on the MPC. These data suggest that neonatal dehydration, when detected and treated early, is not associated with adverse outcomes. Thus, in integrated care settings, breastfeeding should not be discouraged because of fears of dehydration.
Learning Objectives: At the conclusion of this session, the participant will be able to
Keywords: Infant Health, Research
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.