Background: Vitamin K deficiency bleeding (VKDB) in infants is a rare but serious worldwide problem, particularly in Southeast Asia. Apart from exclusive breast-feeding, little is known of materno-fetal risk factors that predispose to VKDB.
Objectives: To assess (a) the relationships between functional vitamin K insufficiency in a large cohort of Thai mothers to that of their newborn infants and (b) the importance of delivery risk factors and maternal intakes of vitamin K as determinants of neonatal vitamin K status.
Methods: Vitamin K status was assessed by measuring undercarboxylated prothrombin (PIVKA-II) in 683 mothers and in the cord blood of their babies by sensitive immunoassay. Dietary phylloquinone (vitamin K1; K1) intakes were assessed in 106 of these mothers by food frequency questionnaire.
Results: Babies were categorized as ‘normal’ (n=590) or ‘high-risk’ (n=93) according to birth weight and delivery type. PIVKA-II was detectable (>0.15 Arbitrary Units (AU)/ml) in 85 mothers (12.4%) and 109 babies (16.0%) with median levels of 0.78 and 1.04 AU/ml in mothers and babies, respectively. ‘High-risk’ babies had both a higher median detectable PIVKA-II concentration than ‘normal-risk’ babies (3.1 vs. 1.0 AU/ml, p=0.02) and a higher prevalence of clinically relevant (>5.0 AU/ml) concentrations (p=006). Mothers with K1 intakes below the U.S. recommended ‘Adequate Intake’ for pregnancy (<90 µg/d) had a higher prevalence of detectable PIVKA-II (18.8%) than those with adequate intakes (3.3%) (p=0.01).
Conclusions: Functional, clinically relevant, vitamin K insufficiency was more common in ‘high-risk’ than ‘normal-risk’ newborns. Vitamin K insufficiency in mothers was linked to lower dietary K1 intakes during pregnancy.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.