Which intervention has a beneficial effect on water and sodium balance in infants with extremely low birth weight?

• A. ACE inhibitors
• B. Diuretics
• C. Prenatal steroids
• D. Fluid restriction

Answer: (C)

Antental glucocorticoids accelerate maturation of fetal renal function, which helps stabilize fluid and electrolyte status after birth. In extremely low birth weight infants, the kidneys are immature and struggle with Na+ reabsorption and water handling; steroids boost renal tubular maturation and improve glomerular filtration, leading to better control of sodium and water balance. This targeted maturation is the reason this intervention best supports fluid homeostasis in these fragile neonates. Other options either don’t address maturation of renal function (ACE inhibitors, fluid restriction) or can disrupt electrolyte balance (diuretics) rather than improve the underlying capacity to regulate fluids.