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. 2023 Jan-Dec;65(1):e15604.
doi: 10.1111/ped.15604.

Neonatal hyperkalemia associated with maternal ritodrine: A retrospective study

Kenichi Suga  1 , Yoshifumi Wakata  2   3 , Manami Suzuki  1   4 , Shunsuke Takeuchi  1   5 , Masashi Suzue  1 , Ryuji Nakagawa  1 , Maki Urushihara  1
Affiliations

Neonatal hyperkalemia associated with maternal ritodrine: A retrospective study

Kenichi Suga et al. Pediatr Int. 2023 Jan-Dec.

Abstract

Background: We recently reported on a late preterm infant born at 36 weeks' gestation with serious arrhythmia due to hyperkalemia associated with long-term maternal ritodrine administration. It is unknown whether ritodrine alone increases the risk of neonatal hyperkalemia in infants born at 34-36 weeks' gestation.

Methods: This single-center, retrospective, cohort study enrolled late preterm infants (34-36 gestational weeks) born between 2004 and 2018. Cases with maternal magnesium sulfate use were not sufficient for statistical analysis and so were excluded from the study. Risk factors for the occurrence of hyperkalemia were determined based on clinical relevance and previous reports.

Results: In all, 212 late preterm infants with maternal ritodrine use and 400 infants without tocolysis were included in the study. Neonatal hyperkalemia occurred in 5.7% (12/212) in the ritodrine group and 1.8% (7/400) in the control group. The risk of neonatal hyperkalemia was significantly increased by maternal ritodrine administration with a crude odds ratio (OR) of 3.37 (95% confidence interval [CI]: 1.30-8.69; p < 0.01) and an adjusted OR of 3.71 (95% CI: 1.41-9.74; p < 0.01) on multivariable analysis. Long-term tocolysis (≥28 days) with ritodrine increased the risk of neonatal hyperkalemia with 9.3% (11/118) of infants developing hyperkalemia (adjusted OR 4.86; 95% CI: 1.59-14.83; p < 0.01). Neonatal hyperkalemia was not found within 2 weeks of ritodrine administration.

Conclusion: This research suggests that late preterm infants born after long-term ritodrine administration are at risk of neonatal hyperkalemia and require special attention.

Keywords: betamimetics; late preterm infants; neonatal hyperkalemia; retrospective cohort study; ritodrine.

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References

REFERENCES

    1. Shinohara S, Sunami R, Uchida Y, Hirata S, Suzuki K. Association between total dose of ritodrine hydrochloride and pulmonary oedema in twin pregnancy: a retrospective cohort study in Japan. BMJ Open. 2017;7:1-5.
    1. Kim MK, Lee SM, Oh JW, Kim SY, Jeong HG, Kim SM, et al. Efficacy and side effect of ritodrine and magnesium sulfate in threatened preterm labor. Obstet Gynecol Sci. 2018;61:63-70.
    1. Hubinont C, Debieve F. Prevention of preterm labour: 2011 update on tocolysis. J Pregnancy. 2011;2011:941057.
    1. Neilson JP, West HM, Dowswell T. Betamimetics for inhibiting preterm labour. Cochrane Database Syst Rev. 2014;2014:CD004352.
    1. Hudalla H, Karmen C, Bruckner T, Wallwiener S, Fluhr H, Michael Z, et al. Tocolysis with the β 2 -sympathomimetic fenoterol does not increase the occurrence of infantile hemangioma in preterm and term infants. Arch Gynecol Obstet. 2018;298:521-7. https://doi.org/10.1007/s00404-018-4830-5

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