ArticleEuropean journal of pediatrics2026
Association between early hyponatremia and neurological diagnoses in infants with perinatal asphyxia.
Article in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To investigate the association between early hyponatremia and long-term neurodevelopmental diagnoses in infants with perinatal asphyxia. This retrospective study included infants born at ≥ 36 weeks of gestation with an ICD-10 diagnosis of perinatal asphyxia and/or hypoxic-ischemic encephalopathy. Data on sodium levels within the first 72 h of life, early postnatal weight change, and clinical follow-up were extracted from medical records. The outcome was death or any ICD-10 diagnoses indicating a neurodevelopmental disorder (NDD), including epileptic, paralytic, hearing, visual and psychiatric/developmental disorders. For multivariable analysis, estimates were adjusted for sex, mode of delivery, and therapeutic hypothermia. Among 269 neonates, 193 (71.7%) had at least one sodium value < 135 mmol/l, 71 (26.4%) < 130 mmol/l and 12 (4.5%) < 125 mmol/l during the first 72 h of life. The median follow-up time was 11.2 years (range 2.4 - 14.8). NDD or death occurred in 57 infants (21.2%). In multivariable analyses, sodium < 125 mmol/l was significantly associated with NDD or death (aOR = 3.85, 95% Cl 1.04-14.22). Sodium < 130 mmol/l was significantly associated with cerebral palsy (aOR = 8.94, 95% Cl 2.24-35.67), epilepsy (aOR = 20.75, 95% Cl 2.39-180.23) and hearing disorders (aOR = 6.09, 95% CI 1.32-28.18).
conclusionsOur study shows that hyponatremia during the first 72 h of life in infants with perinatal asphyxia is associated with an increased risk of later neurodevelopmental disorders. It remains unclear whether hyponatremia contributes causally to adverse outcomes or primarily serves as a biomarker of severe injury. WHAT IS KNOWN: • Perinatal asphyxia may lead to long-term neurodevelopmental disorders, including cognitive impairment, epilepsy, cerebral palsy, and sensory impairments. • Hyponatremia is common in infants with birth asphyxia and has been associated with low Apgar scores and the severity of hypoxic-ischemic encephalopathy. WHAT IS NEW: • In this study, ICD-10 diagnoses of neurological disorders following perinatal asphyxia were examined using an extended follow-up period. • Early hyponatremia was significantly associated with cerebral palsy, epilepsy and hearing disorders.
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