Five-Year Neurodevelopmental Outcome of Neonatal Dehydration

Objective

To determine the long-term outcome of neonatal dehydration.

Study design

We identified 182 newborns who were rehospitalized with dehydration (weight loss ≥12% of birth weight and/or serum sodium ≥150 mEq/L) and 419 randomly selected controls from a cohort of 106,627 term and near-term infants with birth weight ≥2000 g born between 1995 and 1998 in northern California Kaiser Permanente hospitals. Outcomes data were obtained from electronic records, interviews, questionnaire responses, and neurodevelopmental evaluations performed in a masked fashion.

Results

Follow-up data to age at least 2 years were available for 173 of 182 children with a history of dehydration (95%) and 372 of 419 controls (89%) and included formal evaluation at a mean age (±standard deviation) of 5.1 ± 0.12 years for 106 children (58%) and 168 children (40%), respectively. None of the cases developed shock, gangrene, or respiratory failure. Neither crude nor adjusted scores on cognitive tests differed significantly between groups. There was no significant difference between groups in the proportion of children with abnormal neurologic examinations or neurologic diagnoses. Frequencies of parental concerns and reported behavior problems also were not significantly different in the 2 groups.

Conclusions

Neonatal dehydration in this managed care setting was not associated with adverse neurodevelopmental outcomes in infants born at or near term.

Abbreviations: CBCL, Child Behavior Checklist, CI, Confidence interval, ICD, International Classification of Diseases, JIFee, Juvenile and Infant Feeding Study, KPMCP, Kaiser Permanente Medical Care Program, MPC, Motor Performance Checklist, PEDS, Parent Evaluation of Developmental Status, VMI-4, Beery-Buktenica Developmental Test of Visual-Motor Integration, fourth edition, WPPSI-R, Wechsler Preschool and Primary Scale of Intelligence, revised