Language
English
Publication Date
1-1-2026
Journal
Pediatrics Open Science
DOI
10.1542/pedsos.2025-001089
PMID
42453289
PMCID
PMC13367914
PubMedCentral® Posted Date
7-15-2026
PubMedCentral® Full Text Version
Author MSS
Abstract
Objective: Evaluate the effectiveness of an algorithm using urine sodium (Na) concentration to guide dietary Na supplementation compared with standard care to promote growth in infants who are preterm.
Methods: A randomized trial was conducted in 4 neonatal units in Indianapolis, Indiana, involving infants between 250/7 to 296/7 weeks gestation with birthweight > 500 g. Study arms consisted of standard care or use of algorithm beginning at 14 to 17 days postnatal age. The primary outcomes were somatic growth (weight, length, and head circumference) measured by change in Z-score between aged 2 weeks and 36 weeks postmenstrual age (PMA). Secondary outcomes included total body water and body composition.
Results: Of 260 eligible infants, 90 were consented and randomized, with 45 allocated to each arm and 43 in each arm completing the study. Thirty-eight (88%) infants randomized to the study algorithm had a low urine Na that qualified for Na supplementation (4 mEq/kg/d). Infants assigned the algorithm received more Na (5.75 ± 0.96 mEq/kg/d) than infants assigned the standard care (3.62 ± 1.25 mEq/kg/d); caloric intake did not differ. Change in weight Z-score from study entry until 36 weeks PMA was not statistically different between groups (0.16 ± 0.41 vs 0.04 ± 0.63, algorithm vs control; P = .16). Infants assigned the algorithm displayed a significantly more rapid increase in weight between weeks 0 to 7 of the study than infants assigned the standard care. Total body water and fat-free mass did not differ at 32 weeks PMA.
Conclusion: Na supplementation guided by urine Na concentration did not significantly improve weight gain in infants 250/7 to 296/7 weeks gestation at 36 weeks PMA.
Published Open-Access
yes
Recommended Citation
Liberio, Brianna M; Sokol, Gregory M; Rakow, Hannah; et al., "Sodium Supplementation Algorithm to Promote Growth in Infants Who Are Preterm: Randomized Clinical Trial" (2026). Faculty, Staff and Students Publications. 7714.
https://digitalcommons.library.tmc.edu/baylor_docs/7714