Synergic interaction between ritodrine and magnesium sulfate on the occurrence of critical neonatal hyperkalemia: A Japanese nationwide retrospective cohort study
Yukari Yada, Akihide Ohkuchi, Katsufumi Otsuki, Keiji Goishi, Mari Takahashi, Naohiro Yonemoto, Shigeru Saito, Satoshi Kusuda, The Survey Group Studying the Effects of Tocolytic Agents on Neonatal Adverse Events in Japan Society of Perinatal and Neonatal Medicine, Hajime Ota, Kiyotaka Kosugiyama, Kazuhiko Okuyama, Masato Mizushima, H. Negishi, Shinichi Koshida, Mayumi Kasai, Motonari Okabe, Akira Sato, Hiroyuki Adachi, Michio Banzai, Kazuhiro Akaba, Rika Suzuki, Naohisa Ishibashi, Takashi Watanabe, Yoshio Kasuga, Takashi Kameda, Toru Fujiu, Takeshi Takagi, Kenichi Maruyama, Masahiko Higashino, Tomomi Naito, Yoshimasa Kamei, Tetsuya Kunikata, Yoshinori Iitsuka, Harumi Otsuka, Yuka Yamamoto, Mie Yamada, Masaki Daigo, Hironobu Hyodo, Ayumi Sato, Noriko Kataoka, Satoko Yamanaka, Aya Okahashi, Yuki Kojima, Shigenori Kabashima, Yoshie Nakamura, Rina Okuno, Seiko Hirose, Koichi Sugahara, Satsuki Okamoto, Sumiko Hara, Wakako Shima, Takeshi Suzuki, Hideyuki Kagawa, Kenichiro Fujioka, Akiko Kurasaki, Ayako Miura, Isamu Hokuto, Toru Arase, Nobuhiko Taguchi, Kazuki Sekiguchi, Tomoyo Matsuo, Emi Ohnuma, Kana Fujiwara, Miyuki Ogawa, Azusa Uozumi, Noriyuki Yokomichi, Akane Hirose, Mika Okuda, Ayako Fukuyama, Hitoshi Ishimoto, Kanako Mitsuzuka, Shinya Kondo, Miyuki Kitazawa, Norihiko Kikuchi, Yumiko Miyashita, Chiharu Tsutsumi, Shuhei Terada, Shigeru Ohki, Takakazu Kawamura, Masako Yasuda, Yoshiki Soeno, Takumi Kurabayashi, Yoshihisa Nagayama, Satoshi Yoneda, Tomomi Shiga, Seiji Hayashi, Hiroyuki Tsuda, Makoto Oshiro, Takafumi Ushida, Teruyuki Mizutani, H. Asada, Ryousuke Miura, Ryō Tanaka, Noriko Kato, Yuko Sasaki, Takehiko Yokoyama, Takako Hirooka, Takaharu Yamada, Kaori Maruwaka
Abstract
Abstract Our aim was to evaluate the association between ritodrine and magnesium sulfate (MgSO 4 ) and the occurrence of neonatal hyperkalemia or hypoglycemia among late preterm infants in a retrospective cohort study. We used a nationwide obstetrical database from 2014. A total of 4,622 live preterm infants born at 32–36 gestational weeks participated. Fourteen risk factors based on both clinical relevance and univariate analysis were adjusted in multivariable logistic regression analyses. Neonatal hyperkalemia and hypoglycemia occurred in 7.6% (284/3,732) and 32.4% (1,458/4,501), respectively. Occurrence of hyperkalemia was associated with concomitant usage of ritodrine and MgSO 4 compared with no usage (adjusted odds ratio [aOR] 1.53, 95% confidence interval [CI] 1.09–2.15). Occurrence of hypoglycemia was associated with ritodrine alone (aOR 2.58 [CI 2.21–3.01]) and with concomitant usage of ritodrine and MgSO 4 (aOR 2.59 [CI 2.13–3.15]), compared with no usage, and was associated with long-term usage (≥ 48 hours) of ritodrine and cessation directly before delivery. In conclusion, in late preterm infants, usage of ritodrine together with MgSO 4 was associated with occurrence of critical neonatal hyperkalemia, and long-term usage of ritodrine and cessation directly before delivery were associated with neonatal hypoglycemia.