Effects of Antenatal Steroid on Postnatal Fluid Balance in Very Low Birth Weight (VLBW) Infants during the First Week of Life.

Kim,  Jeong Eun; Hur,  Kyung; Choi,  Eun Na; Namgung,  Ran; Park,  Min Soo; Park,  Kook In; Lee,  Chul; Kim,  Myung Jun

Original Article

Journal of the Korean Society of Neonatology 2007;14(2):170-177.
Published online November 1, 2007.

Effects of Antenatal Steroid on Postnatal Fluid Balance in Very Low Birth Weight (VLBW) Infants during the First Week of Life.

Jeong Eun Kim, Kyung Hur, Eun Na Choi, Ran Namgung, Min Soo Park, Kook In Park, Chul Lee, Myung Jun Kim

¹Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea. ranng@yuhs.ac
²Department of Diagnostic Radiology, Seoul, Korea.

산전 스테로이드의 투여가 극소 저출생 체중아의 생후 초기 수분 평형 상태에 미치는 영향

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Abstract

PURPOSE
Antenatal steroid (AS) may result in lower insensible water loss (IWL), and higher urine output (UO) in early life. We examined if the postnatal fluid balance differed between infants exposed to AS or not (control) in VLBW infants.
METHODS
Fifty-four VLBW infants were grouped into AS (n=24) or control (n=30). Fluid intake, UO, IWL and maximal % of weight loss on day 1, day 2, day 3 and day 7 after birth were analyzed. Daily maintenance fluid was determined in each infants by calculation of insensible water loss (IWL=[intake-output]-Delta wt) and UO.
RESULTS
Fluid intake (AS vs control; 117.2+/-33.9 vs 126.0+/-29.6 mL/kg/d, P=0.315), IWL (28.1+/-23.7 vs 21.1+/-20.5 P=0.248), UO and maximal % of weight loss on day 7 were not different between groups: similar findings were observed on day 1, day 2, and day 3 after birth. Neonatal morbidities and clinical relevant factors were not different between groups. The duration of assisted ventilation was shorter in the AS than in the control (10.8+/-9.2 vs 27.6+/-26.2, P=0.002). However, the difference disappeared after adjustment for RDS severity and oxygenation index.
CONCLUSION
VLBW infants exposed to AS did not have an alteration in postnatal fluid balance during the first week of life, when given fluid based on needs reflected by IWL and UO. The decreased need for assisted ventilation in the AS group may be related to the effects of steroid on fetal lung fluid absorption or maturity, but not on postnatal fluid balance.

Key Words: Steroid; Very low birth weight; Insensible water loss; Fluid balance