Restricted versus liberal water intake for preventing morbidity and mortality in preterm infants
Bell EF, Acarregui MJ
The Cochrane database of systematic reviews · 50 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Systematic review (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2014-12-04 · Cochrane Database Syst Rev · vol. 2014 · issue 12 · p. CD000503
- Publisher
- Elsevier BV
- Cited
- 382 citations · more than 100% of similar papers · 16.0× the field average
- Impact
- Top 10% most cited in its field
- References
- 23 works
- Access
- Free to read
- Research areas
- Infant Nutrition and Health · Neonatal Respiratory Health Research · Breastfeeding Practices and Influences
- Keywords
- Necrotizing enterocolitis, Medicine, Bronchopulmonary dysplasia, Low birth weight, Pediatrics, Randomized controlled trial, Clinical trial, Cochrane Library, Intraventricular hemorrhage, Adverse effect, Meta-analysis, Gestational age, Internal medicine, Pregnancy
- MeSH
- humans, enterocolitis, necrotizing, bronchopulmonary dysplasia, intracranial hemorrhages, ductus arteriosus, patent, infant, premature, diseases, dehydration, weight loss, infant, newborn, infant, premature, randomized controlled trials as topic, drinking water
2 authors
From US
- Edward F. BellUniversity of Iowa
- Michael J. AcarreguiUniversity of Iowa
Abstract
Background
Most premature infants are physiologically not sufficiently mature to orally ingest all of their required water and nutrients. Therefore, premature infants rely on their caregivers to regulate their volume of water intake. Thus, the caregiver must determine the amount of water to be given each day to such infants.
Objectives
To determine the effect of water intake on postnatal weight loss and the risks of dehydration, patent ductus arteriosus, necrotizing enterocolitis, bronchopulmonary dysplasia, intracranial hemorrhage, and death in premature infants.
Search methods
Randomized clinical trials (RCTs) identified in previous versions of this review were re-examined and, in each case, retained. Additional trials were sought that compared the outcomes of interest in groups of premature infants who were given different levels of water intake according to an experimental protocol. Such trials were sought in a list of trials provided by the Cochrane Neonatal Review Group, with a PubMed search and in the authors' personal files.This search was updated in 2014.
Selection criteria
Only RCTs of varying water intake in premature infants were included. The review was limited to trials that included infants whose water intake was provided mainly or entirely by intravascular infusion.
Data collection and analysis
The standard methods of The Cochrane Collaboration were used. Study selection and data abstraction were performed independently by each review author. The adverse event rates were calculated for the restricted and liberal water intake groups for each dichotomous outcome, and the relative risk and risk difference were computed. In addition, the maximal weight loss results were recorded and the weighted mean difference was computed.
Main results
The analysis of the five studies taken together indicated that restricted water intake significantly increased postnatal weight loss and significantly reduced the risks of patent ductus arteriosus and necrotizing enterocolitis. With restricted water intake, there were trends toward increased risk of dehydration and reduced risks of bronchopulmonary dysplasia, intracranial hemorrhage, and death but these trends were not statistically significant.
Authors' conclusions
Based on this analysis, the most prudent prescription for water intake to premature infants would seem to be careful restriction of water intake so that physiological needs are met without allowing significant dehydration. This practice could be expected to decrease the risks of patent ductus arteriosus and necrotizing enterocolitis without significantly increasing the risk of adverse consequences.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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