Neonatal Hypernatremic Dehydration: A Retrospective Study of Risk Factors and Treatment

¹Hospital San Pedro. Calle Piqueras, Number 98, Zip Code 26006, Logroño (La Rioja), Spain

*Corresponding author: Patricia Campos Magallón, Calle Marqués de Larios, No. 30, 6ºD, Zip Code 26007, Logroño (La Rioja), Spain, Phone: +34 618016547, E-mail: [email protected]

Received Date: July 28, 2025

Publication Date: April 13, 2026

Citation: Magallón PC, et al. (2026). Neonatal Hypernatremic Dehydration: A Retrospective Study of Risk Factors and Treatment. Neonatal. 7(1):32.

Copyright: Magallón PC, et al. © (2026).

ABSTRACT

Neonatal hypernatremic dehydration is a potentially life-threatening condition that can cause significant neurological damage or death. The objective of this study is to determine its incidence in our setting, identify risk factors, and evaluate any statistical association between treatment and complications, aiming to generate new hypotheses to guide future research that could support standardized management protocols. This is a retrospective observational cohort study of newborns diagnosed with neonatal hypernatremic dehydration between May 2015 and January 2023 in a level III neonatal intensive care unit. Twenty-five patients were included. The main reason for seeking care was referral by another provider to the emergency department (36%). Mean weight loss relative to birth weight was 16%. Identified risk factors were primiparity (p=0.007), exclusive breastfeeding (p<0.001), and male sex (p=0.036). Sixteen percent developed complications. Significant associations were found between complications and initial volume expansion (p=0.007) and a sodium correction rate ≥ 0.5 mEq/L/h (p=0.041). A direct linear relationship was observed between infused intravenous volume and the rate of serum sodium decline (p<0.001, R²=0.733). Early follow-up, especially for high-risk neonates, is crucial to prevent or promptly detect hypernatremic dehydration. This study is limited by its small sample size, single-center design, and possible false positives due to multiple comparisons. Further research is needed to strengthen the evidence base. Hypotheses include evaluating whether restricting initial volume expansion to cases of shock reduces complications and whether initiating intravenous rehydration slowly, with gradual escalation and early combination with enteral feeds, reduces complications by avoiding serum sodium decreases greater than 0.5 mEq/L/h.

Keywords: Neonatal, Dehydration, Hypernatremia, Breastfeeding, Fluid Therapy