TY - JOUR
T1 - Synergic interaction between ritodrine and magnesium sulfate on the occurrence of critical neonatal hyperkalemia
T2 - A Japanese nationwide retrospective cohort study
AU - The Survey Group Studying the Effects of Tocolytic Agents on Neonatal Adverse Events in Japan Society of Perinatal and Neonatal Medicine
AU - Yada, Yukari
AU - Ohkuchi, Akihide
AU - Otsuki, Katsufumi
AU - Goishi, Keiji
AU - Takahashi, Mari
AU - Yonemoto, Naohiro
AU - Saito, Shigeru
AU - Kusuda, Satoshi
AU - Ota, Hajime
AU - Kosugiyama, Kiyotaka
AU - Okuyama, Kazuhiko
AU - Mizushima, Masato
AU - Negishi, Hideaki
AU - Koshida, Shinichi
AU - Kasai, Mayumi
AU - Okabe, Motonari
AU - Sato, Akira
AU - Adachi, Hiroyuki
AU - Banzai, Michio
AU - Akaba, Kazuhiro
AU - Suzuki, Rika
AU - Ishibashi, Naohisa
AU - Watanabe, Takashi
AU - Kasuga, Yoshio
AU - Kameda, Takashi
AU - Fujiu, Toru
AU - Takagi, Takeshi
AU - Maruyama, Kenichi
AU - Higashino, Masahiko
AU - Naito, Tomomi
AU - Kamei, Yoshimasa
AU - Kunikata, Tetsuya
AU - Iitsuka, Yoshinori
AU - Otsuka, Harumi
AU - Yamamoto, Yuka
AU - Yamada, Mie
AU - Daigo, Masaki
AU - Hyodo, Hironobu
AU - Sato, Ayumi
AU - Kataoka, Noriko
AU - Yamanaka, Satoko
AU - Okahashi, Aya
AU - Kojima, Yuki
AU - Kabashima, Shigenori
AU - Nakamura, Yoshie
AU - Okuno, Rina
AU - Hirose, Seiko
AU - Sugahara, Koichi
AU - Miyakoshi, Kei
AU - Hida, Mariko
N1 - Funding Information:
The authors did not receive any funding relevant to this article to disclose. However, this study was supported by the JSPNM. The supporting society had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The suggestion that some cases of cerebral palsy might have occurred in neonates with hypoglycemia and/or hyperkalemia who were born to mothers with either ritodrine or MgSO4 was provided by Takashi Okai, Chairman of the Cause Analysis Committee for Cerebral Palsy of the JCQHC, who recently passed away. We are grateful to Mr. Adam Lebowitz (General Studies Department, Jichi Medical University School of Medicine, Tochigi, Japan) for checking the revised manuscript. The authors would like to thank all of the participating institutions and patients involved in the study for their valuable contributions.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Our aim was to evaluate the association between ritodrine and magnesium sulfate (MgSO4) 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 MgSO4 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 MgSO4 (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 MgSO4 was associated with occurrence of critical neonatal hyperkalemia, and long-term usage of ritodrine and cessation directly before delivery were associated with neonatal hypoglycemia.
AB - Our aim was to evaluate the association between ritodrine and magnesium sulfate (MgSO4) 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 MgSO4 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 MgSO4 (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 MgSO4 was associated with occurrence of critical neonatal hyperkalemia, and long-term usage of ritodrine and cessation directly before delivery were associated with neonatal hypoglycemia.
UR - http://www.scopus.com/inward/record.url?scp=85084291623&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85084291623&partnerID=8YFLogxK
U2 - 10.1038/s41598-020-64687-w
DO - 10.1038/s41598-020-64687-w
M3 - Article
C2 - 32385354
AN - SCOPUS:85084291623
SN - 2045-2322
VL - 10
JO - Scientific reports
JF - Scientific reports
IS - 1
M1 - 7804
ER -