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Turkish Journal of Medical Sciences
Year: 2010  |  Volume: 40  |  Issue: 2  |  Page No.: 185 - 190

Small-for-gestational-age newborns need a special fluid therapy strategy

Alparslan Tonbul, CŁneyt Tayman, Ahmet Karadag, Halise Akca, Nurdan Uras and Mustafa Mansur Tatli    

Abstract: Aim:To determine the fluid requirement of small-for-gestational-age (SGA) newborns and to compare them with that of appropriate for gestational age (AGA) newborns in the first 5 days of life.
Materials and methods: The present study was conducted from January 2007 to August 2007, including newborns with a gestation age of 32-40 weeks, with respiratory problems, feeding problems, and prematurity, and required intravenous fluid for at least 3 days. Two study groups were established: SGA (group 1) and AGA (group 2) according to the Lubchenco scale. All newborns were cared at an ambient humidity of 40% in an incubator and received intravenous fluid therapy. Daily fluid intake was adjusted with urine output, hydration, and weight gain/loss.
Results: During the study period, 124 newborns were admitted to neonatal wards, and only 48 newborns met the inclusion criteria. Two study groups were formed: group 1, SGA (n = 24) and group 2, AGA (n = 24). The comparison of percentage weight loss differences on day 5 with birth weight was 1.39 ± 3.7% in group 1, and 4.29 ± 4.02% in group 2. The mean percentage of weight loss in group 1 was lower than group 2 (P = 0.014). During 5 days, the mean daily fluid requirements in groups 1 and 2 were measured as 103.18 ± 28.68 cc/kg per day and 129.09 ± 25.8 cc/kg per day. The daily fluid requirement in group 1 was lower compared to group 2 (P = 0.003).
Conclusion: SGA newborns need lower fluid requirements, and experience lower weight loss during the first 5 days of life as compared with AGA counterparts, which suggests that fluid requirement of SGA newborns are different from AGA newborns and the fluid therapy of SGA newborns should be special.

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