Metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfate
Abstract In the management of pregnancy, ritodrine has been used to prevent preterm birth, and magnesium sulfate (MgSO4) has been used to prevent preterm labor and preeclampsia. Neonates born to mothers receiving these medications occasionally show an increase in serum potassium concentration. Recen...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-025-85938-8 |
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| author | Masanori Inoue Kazuhito Sekiguchi Haruka Tsushita Naomi Inoue Tomoki Maeda Hiroki Itoh Kenji Ihara |
| author_facet | Masanori Inoue Kazuhito Sekiguchi Haruka Tsushita Naomi Inoue Tomoki Maeda Hiroki Itoh Kenji Ihara |
| author_sort | Masanori Inoue |
| collection | DOAJ |
| description | Abstract In the management of pregnancy, ritodrine has been used to prevent preterm birth, and magnesium sulfate (MgSO4) has been used to prevent preterm labor and preeclampsia. Neonates born to mothers receiving these medications occasionally show an increase in serum potassium concentration. Recently, an elevated risk of neonatal hyperkalemia has been reported, particularly when ritodrine and MgSO4 are co-administered; however, the underlying mechanisms remain unclear. We conducted a retrospective cohort study of 142 preterm infants born between 24 and 36 weeks of gestation, categorized into groups exposed to antenatal ritodrine, MgSO4, both agents, or neither. In addition, we investigated the association between potassium levels and metabolites in the serum of umbilical cord blood from 33 infants exposed to antenatal ritodrine and MgSO4 using a metabolomic analysis. Our findings revealed a significant elevation in serum potassium concentration associated with metabolomic findings of activation of glycolysis and the derived metabolic routes in preterm neonates exposed to both ritodrine and MgSO4. Our data indicate that the concurrent administration of ritodrine and MgSO4 caused distinctive metabolic alterations, potentially leading to an additional increase in the intracellular potassium concentration in the fetus. Consequently, this mechanism may imply an elevation in serum potassium concentration postnatally through the redistribution of potassium. |
| format | Article |
| id | doaj-art-12d694b146b044d6b6d4e51ef4b04221 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-12d694b146b044d6b6d4e51ef4b042212025-01-19T12:17:37ZengNature PortfolioScientific Reports2045-23222025-01-0115111310.1038/s41598-025-85938-8Metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfateMasanori Inoue0Kazuhito Sekiguchi1Haruka Tsushita2Naomi Inoue3Tomoki Maeda4Hiroki Itoh5Kenji Ihara6Department of Pediatrics, Faculty of Medicine, Oita UniversityDepartment of Pediatrics, Faculty of Medicine, Oita UniversityDepartment of Clinical Pharmacy, Faculty of Medicine, Oita UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine, Oita UniversityDepartment of Pediatrics, Faculty of Medicine, Oita UniversityDepartment of Clinical Pharmacy, Faculty of Medicine, Oita UniversityDepartment of Pediatrics, Faculty of Medicine, Oita UniversityAbstract In the management of pregnancy, ritodrine has been used to prevent preterm birth, and magnesium sulfate (MgSO4) has been used to prevent preterm labor and preeclampsia. Neonates born to mothers receiving these medications occasionally show an increase in serum potassium concentration. Recently, an elevated risk of neonatal hyperkalemia has been reported, particularly when ritodrine and MgSO4 are co-administered; however, the underlying mechanisms remain unclear. We conducted a retrospective cohort study of 142 preterm infants born between 24 and 36 weeks of gestation, categorized into groups exposed to antenatal ritodrine, MgSO4, both agents, or neither. In addition, we investigated the association between potassium levels and metabolites in the serum of umbilical cord blood from 33 infants exposed to antenatal ritodrine and MgSO4 using a metabolomic analysis. Our findings revealed a significant elevation in serum potassium concentration associated with metabolomic findings of activation of glycolysis and the derived metabolic routes in preterm neonates exposed to both ritodrine and MgSO4. Our data indicate that the concurrent administration of ritodrine and MgSO4 caused distinctive metabolic alterations, potentially leading to an additional increase in the intracellular potassium concentration in the fetus. Consequently, this mechanism may imply an elevation in serum potassium concentration postnatally through the redistribution of potassium.https://doi.org/10.1038/s41598-025-85938-8Cord bloodHyperkalemiaMagnesium sulfatePreterm infantRitodrine |
| spellingShingle | Masanori Inoue Kazuhito Sekiguchi Haruka Tsushita Naomi Inoue Tomoki Maeda Hiroki Itoh Kenji Ihara Metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfate Scientific Reports Cord blood Hyperkalemia Magnesium sulfate Preterm infant Ritodrine |
| title | Metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfate |
| title_full | Metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfate |
| title_fullStr | Metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfate |
| title_full_unstemmed | Metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfate |
| title_short | Metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfate |
| title_sort | metabolomic characteristics of cord blood from neonates with hyperkalemia after antenatal exposure to ritodrine and magnesium sulfate |
| topic | Cord blood Hyperkalemia Magnesium sulfate Preterm infant Ritodrine |
| url | https://doi.org/10.1038/s41598-025-85938-8 |
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