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. 2025 Mar;45(3):305-311.
doi: 10.1038/s41372-024-02141-9. Epub 2024 Oct 17.

Somatic growth outcomes in response to an individualized neonatal sodium supplementation protocol

Elliot J Stalter  1 , Silvia L Verhofste  1 , John M Dagle  1 , Emily J Steinbach  1 , Patrick Ten Eyck  2 , Linder Wendt  2 , Jeffrey L Segar #  3 , Lyndsay A Harshman #  4   5
Affiliations

Somatic growth outcomes in response to an individualized neonatal sodium supplementation protocol

Elliot J Stalter et al. J Perinatol. 2025 Mar.

Abstract

Objective: Evaluate the impact of a sodium (Na) supplementation protocol based upon urine Na concentration on growth parameters and morbidities.

Study design: Retrospective cohort study of infants 260/7-336/7 weeks gestational age (GA) cared for before (2012-15, n = 310) and after (2016-20, n = 382) implementation of the protocol. Within- and between-group changes over time were assessed using repeated measures generalized linear models.

Results: For infants 260/7-296/7 weeks GA, utilization of the protocol was associated with increased mean body weight z-score at 8-weeks postnatal age, increased mean head circumference z-score at 16-weeks postnatal age, and decreased time on mechanical ventilation (all p < 0.02). No impact on growth was identified for infants 30-336/7 weeks GA. Incidences of hypertension, hypernatremia, bronchopulmonary dysplasia, necrotizing enterocolitis, and culture positive sepsis were unaffected by the protocol.

Conclusion: Protocolized Na supplementation is associated with improved growth and reduced time on invasive mechanical ventilation in extremely preterm infants without increasing incidence of morbidities.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: All methods were performed in accordance with relevant guidelines and regulations. Review of patient data was approved with waived consent by the University of Iowa Institutional Review Board (202203591) due to the retrospective nature of the study.

Figures

Figure 1.
Figure 1.
Flow diagram demonstrating subject enrollment, application of exclusion criteria, and cohort formation.
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