{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T16:16:00Z","timestamp":1778948160428,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003785","name":"Guangdong Medical Research Foundation","doi-asserted-by":"publisher","award":["B2025361"],"award-info":[{"award-number":["B2025361"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003785","name":"Guangdong Medical Research Foundation","doi-asserted-by":"publisher","award":["B2025681"],"award-info":[{"award-number":["B2025681"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003785","name":"Guangdong Medical Research Foundation","doi-asserted-by":"publisher","award":["C2023025"],"award-info":[{"award-number":["C2023025"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientific Research Project on Traditional Chinese Medicine of Guangdong Province","award":["20261040"],"award-info":[{"award-number":["20261040"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pregnancy-associated sepsis poses significant maternal, fetal and neonatal risks, with acute kidney injury (AKI) being a critical complication. The dynamic relationship between serum sodium trajectories and AKI in this population remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, 138 pregnant patients with sepsis were analyzed using the MIMIC-IV 3.1 database. Three serum sodium trajectory groups were identified via group-based trajectory modeling (GBTM). AKI was defined per KDIGO criteria. Analyses employed logistic regression, inverse probability weighting, multivariable adjustments and cubic spline models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three distinct trajectories emerged: Group 1 (low initial sodium that subsequently increased, n\u2009=\u200934), Group 2 (stable sodium levels, n\u2009=\u200983), and Group 3 (high sodium levels throughout, n\u2009=\u200921). Groups 1 and 3 exhibited higher AKI incidence (ORs: 4.04 [95%CI: 1.63-9.96] and 3.97 [95%CI: 1.33-11.87], respectively; both\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), prolonged ICU stay hours(72, 118 vs 47,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and elevated SOFA scores (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01) compared to Group 2. Cubic spline analysis revealed a U-shaped risk relationship, with AKI incidence rising at sodium levels &gt;145\u2005mmol\/L (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value for overall was 0.037 and for nonlinear was 0.021).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dynamic sodium trajectories, particularly low initial sodium that subsequently increased, independently predict AKI and adverse outcomes in pregnancy-associated sepsis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666251386401","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T15:41:41Z","timestamp":1762270901000},"page":"540-551","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Sodium Dynamics and Acute Kidney Injury in Pregnancy Associated Sepsis: Insights from Group-Based Trajectory Modeling"],"prefix":"10.1177","volume":"41","author":[{"given":"Pei","family":"Tao","sequence":"first","affiliation":[{"name":"Guangdong Women and Children Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuangming","family":"Cai","sequence":"additional","affiliation":[{"name":"Guangdong Women and Children Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Ling","sequence":"additional","affiliation":[{"name":"The Fifth Affiliated Hospital of Guangzhou Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiping","family":"Luo","sequence":"additional","affiliation":[{"name":"Guangdong Women and Children Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanshun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Guangdong Women and Children Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-3701","authenticated-orcid":false,"given":"Shan","family":"Huang","sequence":"additional","affiliation":[{"name":"Guangdong Women and Children 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