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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Neonatal hyperkalemia associated with maternal ritodrine: A retrospective study
Kenichi Suga1, Yoshifumi Wakata2,3, Manami Suzuki1,4
1Department of Pediatrics, Tokushima University Hospital, Tokushima, Japan.
Summary
Maternal ritodrine use, particularly long-term, significantly increases the risk of neonatal hyperkalemia in late preterm infants. These infants require close monitoring for this potentially serious condition.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Obstetrics
Background:
- Previous case reports highlighted neonatal hyperkalemia linked to maternal ritodrine.
- The specific risk of ritodrine monotherapy for neonatal hyperkalemia in late preterm infants remained unclear.
Purpose of the Study:
- To investigate the association between maternal ritodrine administration and neonatal hyperkalemia in late preterm infants (34-36 weeks gestation).
Main Methods:
- Retrospective cohort study of late preterm infants (2004-2018).
- Compared infants with maternal ritodrine exposure to a control group without tocolysis.
- Excluded cases with maternal magnesium sulfate use due to insufficient statistical power.
Main Results:
- Neonatal hyperkalemia occurred in 5.7% of infants exposed to ritodrine versus 1.8% in controls.
- Maternal ritodrine administration significantly increased the risk of neonatal hyperkalemia (adjusted OR 3.71).
- Long-term ritodrine use (≥28 days) further elevated this risk (adjusted OR 4.86).
Conclusions:
- Late preterm infants born after long-term maternal ritodrine exposure are at increased risk for neonatal hyperkalemia.
- These infants warrant special attention and monitoring for hyperkalemia.
- Hyperkalemia was not observed within two weeks of ritodrine administration.
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