Evaluation of hydration status and fluid intake among low risk postpartum women in local community delivered  in Hospital Ampang.

Abstract Background: Adequate fluid intake is very crucial for mothers during postpartum as any dehydration that ensues during this period may predispose them to the risk of developing venous thromboembolism event. Yet, the sociocultural influences may have deterred some of them from adequate fluid intake especially those from Asian region. This study aims to determine hydration status of low risk postpartum women during postpartum period among Malaysian women.Methods: A prospective observationalstudy involving assessment of hydrational status at 3 points; after 24 hours, at the 3rd week and at the 6th week postpartum was conducted. Apart from hydrational status where patients were requested to recordon weekly basis of their input and output fluid intake in a diary, they also underwent a series of biochemical parameters assessment.Results: 56 patients met the inclusion criteria. The sociodemographic data were analysed decriptively whereby all in the patients were in reproductive age group, with mean (SD) age of 27.96 (4.46) years.The majority were of Malay ethnicity 94.6% and 66.1% were multiparous. As many as 92% of them had at least secondary level of education and more than half were employed (55.4%). Subsequent analysis (n=15) at 3rd and 6th week following womenwho had completed all 3 follow ups showed; statistically significant evidence of underhydration from the biochemical test results. Repeated analysisat the 3rd week and 6th week revealed that there were significant differences using Friedman test in levels of urea (p=0.001b), creatinine(0.008b), as well as plasma osmolality (p<0.001b). Similarly with urine specific gravity(p=0.002) and urine osmolality (0.002a) calculated with repeated measures ANOVA from baseline. This correlated with the overall lack offluid intake taken by patients which recorded 1.78L/day at 3rd week and 2.13L/day by 6th week, values which were lower than recommended amount for nursing mother.Conclusion: The results suggested that lower fluid intake among low risk postpartum women during the postpartum period may predisposes risk of venous thromboembolism. Emphasizing adequate amount of fluid intake among low risk post partum women is crucial and will reduce possible risk of venous thromboembolism.