Evidence map›Paper›PMID 40991028›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

Early fluid status and severe intraventricular hemorrhage or death in extremely preterm infants.

Lucinda J Weaver, Samuel J Gentle, Arie Nakhmani, Fazlur Rahman, Namasivayam Ambalavanan, Vivek V Shukla, Christine Stoops, David Askenazi, Colm P Travers

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In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lucinda J WeaverDepartment of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA.
Samuel J GentleDepartment of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA.
Arie NakhmaniDepartment of Electrical and Computer Engineering, University of Alabama at Birmingham, Birmingham, AL, USA.
Fazlur RahmanDepartment of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA.
Namasivayam AmbalavananDepartment of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA.
Vivek V ShuklaDepartment of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA.
Christine StoopsDepartment of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA.
David AskenaziDepartment of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA.
Colm P TraversDepartment of Pediatrics, University of Alabama at Birmingham, 1700 6Th Avenue South, WIC, Suite 9380, Birmingham, AL, 35233, USA. cptravers@uabmc.edu.ORCID http://orcid.org/0000-0002-3218-1024

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMeasures of early postnatal fluid balance may be associated with severe intraventricular hemorrhage (sIVH) and/or death in extremely preterm infants in the first postnatal week.

methodsA single-center, retrospective cohort study including actively treated inborn infants weighing ≥ 400 g and 22-27 weeks' gestation from 2014-2021. Longitudinal mixed effect models compared daily fluid balance covariates including serum sodium, percent weight change, total fluid intake, urine output, and fluid balance (daily weight - birth weight /birth weight × 100) among infants with and without sIVH or death, during the first seven postnatal days. Multiple regression and machine learning models were developed to predict sIVH and/or death. Variables that were incorporated into the models included measures of fluid balance, gestational age, birth weight, antenatal corticosteroids, multiples, and sex.

resultsWe included 932 infants with mean ± SD gestational age of 25w2d ± 11d and birth weight of 746 ± 212 g of whom 195 (20.9%) had sIVH and/or death. Lower percentage weight change (p < 0.001), higher total fluid intake (p = 0.007), higher sodium (p = 0.007), and positive early fluid balance (p < 0.001) were associated with sIVH and/or death even after adjustment for baseline characteristics. The area under the receiver-operating curve (AUC) for regression models predicting sIVH and/or death incorporating baseline characteristics improved after adding fluid balance measures from 0.75 to 0.80, while the AUC for machine learning models improved from 0.72 to 0.84.

conclusionsIn extremely preterm infants, early fluid status measures were associated with risk of sIVH and/or death. The addition of fluid status measures improves the performance of models predicting sIVH and/or death.

Indexed as

Cerebral Intraventricular HemorrhageInfant, Extremely PrematureInfant, Premature, DiseasesWater-Electrolyte BalanceBirth WeightFemaleGestational AgeHumansInfantInfant, NewbornMachine LearningMaleRetrospective StudiesSodiumSodiumCerebral intraventricular hemorrhageHypernatremiaHyponatremiaInfantMortalityPrematureWater-electrolyte balance

Identifiers

PMID40991028
PMCPMC12685979

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.