Authors: Mohammed El A Zayed, Sarah Omer Mohammed Gadim, Omer Saeed Magzoub.
Serum sodium concentration of ≥ 150mmol/l in neonates is known as neonatal hypernatremia. The risk of hypernatremia is high in newborns as result of inability to control their fluid intake and their large body surface area to weight or height ratio which results in high insensible water losses.
Objectives: To determine clinical presentation and associated laboratory findings of hypernatremia in Neonates admitted to Al-Obied Specialized Pediatric Hospital, North Kordofan State, Sudan during the period from January 2020 - January 2022.
Methods: This is a descriptive, observational, cross-sectional and hospital-based study conducted at Al-Obied Specialized Pediatric Hospital. Data was extracted from the patient records and then re-entered into a predesigned data collection form. Data then cleaned and entered into Microsoft excel data sheet and analyzed using SPSS version21.
Results: A total of 206 of the participants were included in this study. Most patients (92.2%) were delivered at term with normal APGAR score in (86.9%). The birth weight for majority 104 (50.5%) of the respondents was found to be from 1.5 to 2.5 kg. Serum Na was found to be 151 -170 mmol/l in 124 (68.9%), 170 – 190 mmol/l in 41 (22.8%), 190 – 200 mmol/l in 10 (5.6%) of them and more than 200 mmol/l in 5 (2.8%) of the participants. The most commonly reported associated neonatal complication was found to be sepsis which reported in 185 (89.8%) of the participants followed by neonatal jaundice which reported in 64 (31.1%) of the neonates, feeding refusa in 55 (26.7%) of neonates, diarrhea in 28 (13.6%), vomiting in 25 (12.1%) of the neonates and 22 (10.7%) were with congenital malformations. Neurological symptoms (convulsions, irritability & lethargy) were reported in 70 (34%) of the participants. The most reported maternal complications were febrile illness in 35 (17%) of the participants 23 (11.2%) were with UTI 20 (9.7%) had PIH. C-reactive protein (CRP) was found elevated in all participants. Renal function tests (RFTs) was impaired in 180 (87.4%) of the participants and normal in 26 (12.6%).
Conclusion: Birth weight significantly associated with Hypernatremia. The most common reported clinical presentation was found to be sepsis, followed by neonatal jaundice, feeding refusal, diarrhea, vomiting and congenital malformations. Neurological symptoms (convulsions, irritability & lethargy) were reported as well. Other complications included sepsis and acute kidney injury (AKI). The most common laboratory findings which found to be associated with neonatal hypernatremia were elevated C-reactive protein (CRP), urea and creatinine.