Neonatal hyperkalemia associated with maternal ritodrine: A retrospective study.

Autor: Suga K; Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan., Wakata Y; Department of Medical Informatics, Tokushima University Hospital, Tokushima, Japan.; Health Information Management Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan., Suzuki M; Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan.; Department of Pediatrics, Tokushima Red Cross Hospital, Tokushima, Japan., Takeuchi S; Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan.; Department of Pediatrics, Tsurugi Municipal Handa Hospital, Tokushima, Japan., Suzue M; Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan., Nakagawa R; Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan., Urushihara M; Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan.
Jazyk: angličtina
Zdroj: Pediatrics international : official journal of the Japan Pediatric Society [Pediatr Int] 2023 Jan-Dec; Vol. 65 (1), pp. e15604.
DOI: 10.1111/ped.15604
Abstrakt: 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.
(© 2023 Japan Pediatric Society.)
Databáze: MEDLINE
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