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Total body water in full term and preterm newborns: systematic review and meta-analysis

Total body water in full term and preterm newborns: systematic review and meta-analysis
Total body water in full term and preterm newborns: systematic review and meta-analysis
Background: Total body water (TBW) is one component of fat-free mass and changes in TBW are influenced by fluid shifts (especially during transition to postnatal life), electrolyte balance and nutritional status. Normal values for term-born neonates and preterm infants at birth have not been defined in large cohorts, limiting investigation into its monitoring and use in clinical practice.

Objective: to systematically review the evidence base for percentage of TBW in term-born infants, quantify the effect of prematurity on TBW at birth, and describe normal progression of TBW over time in preterm infants.

Methods: systematic review of Medline, Web of Science Core Collection and EBSCO-CINAHL (January 1946 to January 2020). Included articles used dilutional methods to assess TBW.

Results: searches identified 2349 articles of which 22 included data suitable for analysis. Mean TBW in term-born newborns was 73.8% (95% CI 72.47% to 75.06%, 15 studies, 433 infants). Meta-regression showed that TBW was higher in preterm infants (up to 90% at 26 weeks gestation, dropping to 75% at 36 weeks corrected gestation) and was negatively correlated with gestation at birth, falling 1.44% per week (95% CI 0.63% to 2.24%, 9 studies, 179 infants). Analysis of TBW over time during the ex utero growth of preterm infants was not possible due to paucity of data.

Conclusion: this review defines the normal TBW percentage in term-born infants and confirms and quantifies previous findings that preterm infants have a higher TBW percentage.
growth, neonatology
1359-2998
542-548
Young, Aneurin
457b536d-6015-4855-8e4c-0a665a9a2bb1
Brown, Lisa K
03ad5912-0e84-4f46-87c2-f245113b2bcb
Ennis, Sarah
7b57f188-9d91-4beb-b217-09856146f1e9
Johnson, Mark
ce07b5dd-b12b-47df-a5df-cd3b9447c9ed
Beattie, R.M.
977a2f68-2bcf-4436-87e7-28a39952adda
Young, Aneurin
457b536d-6015-4855-8e4c-0a665a9a2bb1
Brown, Lisa K
03ad5912-0e84-4f46-87c2-f245113b2bcb
Ennis, Sarah
7b57f188-9d91-4beb-b217-09856146f1e9
Johnson, Mark
ce07b5dd-b12b-47df-a5df-cd3b9447c9ed
Beattie, R.M.
977a2f68-2bcf-4436-87e7-28a39952adda

Young, Aneurin, Brown, Lisa K, Ennis, Sarah, Johnson, Mark and Beattie, R.M. (2021) Total body water in full term and preterm newborns: systematic review and meta-analysis. Archives of Disease in Childhood - Fetal and Neonatal Edition, 106 (5), 542-548. (doi:10.1136/archdischild-2020-321112).

Record type: Article

Abstract

Background: Total body water (TBW) is one component of fat-free mass and changes in TBW are influenced by fluid shifts (especially during transition to postnatal life), electrolyte balance and nutritional status. Normal values for term-born neonates and preterm infants at birth have not been defined in large cohorts, limiting investigation into its monitoring and use in clinical practice.

Objective: to systematically review the evidence base for percentage of TBW in term-born infants, quantify the effect of prematurity on TBW at birth, and describe normal progression of TBW over time in preterm infants.

Methods: systematic review of Medline, Web of Science Core Collection and EBSCO-CINAHL (January 1946 to January 2020). Included articles used dilutional methods to assess TBW.

Results: searches identified 2349 articles of which 22 included data suitable for analysis. Mean TBW in term-born newborns was 73.8% (95% CI 72.47% to 75.06%, 15 studies, 433 infants). Meta-regression showed that TBW was higher in preterm infants (up to 90% at 26 weeks gestation, dropping to 75% at 36 weeks corrected gestation) and was negatively correlated with gestation at birth, falling 1.44% per week (95% CI 0.63% to 2.24%, 9 studies, 179 infants). Analysis of TBW over time during the ex utero growth of preterm infants was not possible due to paucity of data.

Conclusion: this review defines the normal TBW percentage in term-born infants and confirms and quantifies previous findings that preterm infants have a higher TBW percentage.

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Young_FNN_MAR21 - Accepted Manuscript
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Accepted/In Press date: 12 March 2021
e-pub ahead of print date: 31 March 2021
Published date: 19 August 2021
Additional Information: Publisher Copyright: ©
Keywords: growth, neonatology

Identifiers

Local EPrints ID: 447723
URI: http://eprints.soton.ac.uk/id/eprint/447723
ISSN: 1359-2998
PURE UUID: 70dc6d87-5598-44d1-be88-af5366b965ca
ORCID for Aneurin Young: ORCID iD orcid.org/0000-0003-3549-3813
ORCID for Sarah Ennis: ORCID iD orcid.org/0000-0003-2648-0869
ORCID for Mark Johnson: ORCID iD orcid.org/0000-0003-1829-9912

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Date deposited: 18 Mar 2021 17:59
Last modified: 17 Mar 2024 06:25

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Contributors

Author: Aneurin Young ORCID iD
Author: Lisa K Brown
Author: Sarah Ennis ORCID iD
Author: Mark Johnson ORCID iD
Author: R.M. Beattie

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