Document Detail

Reference chart for relative weight change to detect hypernatraemic dehydration.
MedLine Citation:
PMID:  16880225     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The validity of the rule of thumb that infants may have a weight loss of 10% in the first days after birth is unknown. We assessed the validity of this and other rules to detect breast-fed infants with hypernatraemic dehydration.
DESIGN: A reference chart for relative weight change was constructed by the LMS method. The reference group was obtained by a retrospective cohort study.
PARTICIPANTS: 1544 healthy, exclusively breast-fed infants with 3075 weight measurements born in the Netherlands and 83 cases of breast-fed infants with hypernatraemic dehydration obtained from literature.
RESULTS: The rule of thumb had a sensitivity of 90.4%, a specificity of 98.3% and a positive predictive value of 3.7%. Referring infants if their weight change is below -2.5 SDS (0.6th centile) in the reference chart in the first week of life and using the rule of thumb in the second week had a sensitivity of 85.5%, a specificity of 99.4% and a positive predictive value of 9.2%.
CONCLUSIONS: The rule of thumb is likely to produce too many false positive results, assuming that for screening purposes the specificity needs to be high. A chart for relative weight change can be helpful to detect infants with hypernatraemic dehydration.
Paula van Dommelen; Jacobus P van Wouwe; Jacqueline M Breuning-Boers; Stef van Buuren; Paul H Verkerk
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Publication Detail:
Type:  Journal Article; Multicenter Study; Validation Studies     Date:  2006-07-31
Journal Detail:
Title:  Archives of disease in childhood     Volume:  92     ISSN:  1468-2044     ISO Abbreviation:  Arch. Dis. Child.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-22     Completed Date:  2007-06-13     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  0372434     Medline TA:  Arch Dis Child     Country:  England    
Other Details:
Languages:  eng     Pagination:  490-4     Citation Subset:  AIM; IM    
TNO Quality of Life, Leiden, The Netherlands.
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MeSH Terms
Breast Feeding
Dehydration / diagnosis*,  epidemiology
Epidemiologic Methods
Evidence-Based Medicine
Hypernatremia / diagnosis*,  epidemiology
Infant Care / methods*
Infant, Newborn
Netherlands / epidemiology
Reference Values
Referral and Consultation
Weight Loss*
Comment In:
Arch Dis Child. 2007 Jun;92(6):474-5   [PMID:  17515616 ]
Arch Dis Child. 2008 Mar;93(3):264-5   [PMID:  18319389 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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