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KMID : 0438520070140020170
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Journal of the Korean Society of Neonatology
2007 Volume.14 No. 2 p.170 ~ p.177
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Effects of Antenatal Steroid on Postnatal Fluid Balance in Very Low Birth Weight (VLBW) Infants during the First Week of Life
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Kim Jeong-Eun
Choi Eun-Na
Namgung Ran
Park Min-Soo
Park Kook-In
Lee Chul
Kim Myung-Joon
Hur Kyung
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Abstract
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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]-△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.
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KEYWORD
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Steroid, Very low birth weight, Insensible water loss, Fluid balance
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