Vitamin K insufficiency and the prophylaxis strategy in term healthy infants: A multicentre study.

Autor: Perrone S; Neonatology Unit, Department of Medicine and Surgery, University of Parma, Pietro Barilla Children's Hospital, Parma, Italy., De Bernardo G; Division of Pediatrics Neonatology and NICU, Ospedale Buon Consiglio Fatebenefratelli, Naples, Italy., Lembo C; Department of Neonatology, APHP, Necker-Enfants Malades Hospital, Paris, France., Dell'Orto V; Neonatology Unit, Department of Medicine and Surgery, University of Parma, Pietro Barilla Children's Hospital, Parma, Italy., Giordano M; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Beretta V; Neonatology Unit, Department of Medicine and Surgery, University of Parma, Pietro Barilla Children's Hospital, Parma, Italy., Petrolini C; Neonatology Unit, Department of Medicine and Surgery, University of Parma, Pietro Barilla Children's Hospital, Parma, Italy., Gambini L; Neonatology Unit, Department of Medicine and Surgery, University of Parma, Pietro Barilla Children's Hospital, Parma, Italy., Toni AL; University of Siena, Siena, Italy., Parigi G; University of Siena, Siena, Italy., Fontanarosa I; University of Siena, Siena, Italy., Natale MP; Neonatology and NICU Di Venere Hospital, Bari, Italy., D'Amato G; Neonatology and NICU Di Venere Hospital, Bari, Italy., Sordino D; Department of Emergency, NICU, A.O.R.N. Santobono-Pausillipon, Naples, Italy., Buonocore G; University of Siena, Siena, Italy.
Jazyk: angličtina
Zdroj: European journal of clinical investigation [Eur J Clin Invest] 2024 Apr; Vol. 54 (4), pp. e14141. Date of Electronic Publication: 2023 Dec 09.
DOI: 10.1111/eci.14141
Abstrakt: Background/aim: Late vitamin K deficiency bleeding (VKDB) during early infancy is a serious problem worldwide. Vitamin K (VK) deficiency commonly occurs in newborns who are exclusively breastfed. Protein Induced by VK Absence (PIVKA-II) has been identified as an early indicator of subclinical VK deficiency in neonates, surpassing prothrombin time. To assess PIVKA-II levels at 48 h, 1 and 3 months of age in full-term newborns who were exclusively breastfed and received varying VKDB prophylaxis regimens.
Methods: A prospective observational study was conducted in four hospitals, enrolling 105 newborns. PIVKA-II levels were measured using a sandwich-type enzyme-linked immunosorbent assay.
Results: At 48 h of age, there was no significant difference in PIVKA-II concentrations between newborns who received intramuscular administration of 1 mg of phylloquinone (VK1) and those who received oral administration of 2 mg of VK1 at birth. At 1 and 3 months of life, infants who received any supplementation regimen between 2 and 14 weeks exhibited significantly lower PIVKA-II concentrations compared to infants who received only 1 mg of intramuscular VK1 at birth. The prophylaxis involving a dose of 1 mg of intramuscular VK1 at birth followed by oral administration of 150 μg/day of VK1 from the 2nd to the 14th week of life showed the lowest PIVKA-II blood concentrations.
Conclusions: Oral supplementation of VK1 after discharge significantly reduced PIVKA-II concentrations in exclusively breastfed term infants. These findings suggest the importance of oral VK1 supplementation in exclusively breastfed infants during their first 3 months of life to avoid the risk of VK insufficiency.
(© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)
Databáze: MEDLINE
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