Original Article

Journal of Perinatology (2008) 28, 123–128; doi:10.1038/sj.jp.7211895; published online 29 November 2007

Fluid regimens in the first week of life may increase risk of patent ductus arteriosus in extremely low birth weight infants

B E Stephens1,2, R A Gargus2,3, R V Walden1,4, M Mance1, J Nye1, L McKinley1, R Tucker1 and B R Vohr1

  1. 1Department of Pediatrics, Women and Infants' Hospital, Providence, RI, USA
  2. 2Department of Pediatrics, Rhode Island Hospital, Providence, RI, USA
  3. 3Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
  4. 4Pediatrix of Dallas, Richardson, TX, USA

Correspondence: Dr BE Stephens, Department of Pediatrics, Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905, USA. E-mail: bstephens@wihri.org

Received 13 June 2007; Revised 23 October 2007; Accepted 5 November 2007; Published online 29 November 2007.

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Abstract

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.

Study Design:

 

A total of 204 ELBW (less than or equal to32 weeks, less than or equal to1250 g) infant survivors were grouped into low-, intermediate- and high-fluid groups. chi 2 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.

Result:

 

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.

Conclusion:

 

High fluid intake (>170 ml kg-1 day-1) in the first days of life is associated with increased risk of PDA.

Keywords:

fluid, PDA, ELBW

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