{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:52:23Z","timestamp":1767768743873,"version":"3.48.0"},"reference-count":99,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Fluid overload (FO) is a prevalent clinical challenge in preterm infants, contributing to multiorgan dysfunction and adverse outcomes. This review synthesizes the pathophysiology, clinical implications, and management strategies of FO to advance fluid management in preterm neonates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed literature to define FO criteria, delineate its mechanisms (e.g., renal immaturity, endothelial glycocalyx impairment), and analyze associations with systemic complications. Current monitoring technologies and therapeutic interventions were evaluated. As a narrative review, literature identification and data extraction were conducted based on the research question and inclusion criteria without adhering to formal systematic review guidelines. All original studies cited in this review reported obtaining approval from institutional ethics committees and informed consent from parents or guardians. As a secondary analysis of published literature, this study does not involve new patient data and therefore required no additional ethical approval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>FO pathogenesis involves underdeveloped renal function, compromised skin barriers, glycocalyx damage, and hypoalbuminemia. FO can lead to multisystem adverse outcomes. Noninvasive monitoring\u2014echocardiography, bioelectrical impedance analysis (BIA), and lung ultrasound\u2014demonstrates high clinical utility. Effective management includes strict fluid restriction, diuretic, and albumin infusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Optimizing FO management requires multimodal monitoring and individualized fluid regimens. Future research should prioritize refining assessment standards and developing targeted interventions to improve neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2025.1691874","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:47:54Z","timestamp":1767768474000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Advancements in research on fluid overload in preterm infants\u2014a narrative review"],"prefix":"10.3389","volume":"13","author":[{"given":"Xinyi","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuyue","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linxiao","family":"Wan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenbin","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.1016\/s2214-109x(18)30451-0","article-title":"Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis","volume":"7","author":"Chawanpaiboon","year":"2019","journal-title":"Lancet Glob Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1016\/s0140-6736(23)00878-4","article-title":"National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis","volume":"402","author":"Ohuma","year":"2023","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1001\/jamapediatrics.2022.1622","article-title":"Global, regional, and national incidence and mortality of neonatal preterm birth, 1990\u20132019","volume":"176","author":"Cao","year":"2022","journal-title":"JAMA Pediatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"805","DOI":"10.7499\/j.issn.1008-8830.2005080","article-title":"Expert consensus on nutritional management of preterm infants with bronchopulmonary dysplasia","volume":"22","author":"Zhang","year":"2020","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"B5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3233\/npm-190309","article-title":"A physiological approach to fluid and electrolyte management of the preterm infant: review","volume":"13","author":"Segar","year":"2020","journal-title":"J Neonatal Perinatal Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1542\/peds.107.6.1309","article-title":"Outcome in children receiving continuous venovenous hemofiltration","volume":"107","author":"Goldstein","year":"2001","journal-title":"Pediatrics"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1097\/ccm.0000000000002425","article-title":"American College of critical care medicine clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock","volume":"45","author":"Davis","year":"2017","journal-title":"Crit Care Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/s00467-022-05514-4","article-title":"Neonatal fluid overload-ignorance is no longer bliss","volume":"38","author":"Weaver","year":"2023","journal-title":"Pediatr Nephrol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1038\/s41390-019-0579-1","article-title":"The impact of fluid balance on outcomes in premature neonates: a report from the AWAKEN study group","volume":"87","author":"Selewski","year":"2020","journal-title":"Pediatr Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.siny.2017.01.002","article-title":"Water balance in the fetus and neonate","volume":"22","author":"Lindower","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1007\/s00134-011-2231-3","article-title":"Weight-based determination of fluid overload status and mortality in pediatric intensive care unit patients requiring continuous renal replacement therapy","volume":"37","author":"Selewski","year":"2011","journal-title":"Intensive Care Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1159\/000076015","article-title":"Stratum corneum maturation. 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