Neonatal Hypernatremia Dehydration and Thrombocytopenia: Its Prevalence and Relation with Prognosis

Background and Aim: Understanding the risk factors for neonatal hypernatremic dehydration (NHD) may help to control the problems of these infants. In this study, the status of the platelet in NHD infants and its relation with prognosis has been evaluated.Methods: This study was performed on 390 neonates referred to the neonatal clinic , emergency ward and Neonatal Intensive Care Unit in Ghaem Hospital, Mashhad, Iran from 2011-2017. Demographic data, signs of disease, physical examination, and laboratory investigations were evaluated in these patients. At first, based on the serum sodium level, the infants were divided into two groups: isonatremia (serum sodium level< 150 mEq/L) and hypernatremia (serum sodium level ≥ 150 mEq/L). In the next stage, the infants were divided into two groups: hypernatremic dehydration with normal platelet status (platelet≥ 150,000 /mcl) and hypernatremic dehydration along with thrombocytopenia (platelet< 150,000 /mcl). In the next step, the NHD infants were followed up using the questionnaire existing in Denver Developmental Test II (DDT II) in 6, 12, 18, 2, 30 and 36 months. Results: Thrombocytopenia was observed in 41% of patients with hypernatremia and 6% of isonatremic infants (p <0.05). Significant differences were found between the groups of normal platelets and low platelets in terms of age, sex, weight loss, blood glucose, sodium, blood urea nitrogen, creatinine, complications and prognosis (p ˂0.05).Conclusion: Our findings showed a strong relationship between hypernatremia and thrombocytopenia in NHD infants. There were more complications and worse prognosis in patients with thrombocytopenia (p <0.05).