vitamin-k-1 and Infant--Premature--Diseases

This review summarizes current knowledge on vitamin K for the paediatrician. Vitamin K is a fat-soluble vitamin, present in plants as phylloquinone and produced by bacteria as menaquinone. It is acting as a co-factor for gamma-glutamyl carboxylase. This enzyme is responsible for post-translational modification of some glutamate side chains to gamma-carboxyglutamate. The majority of gamma-carboxylated proteins function in blood coagulation; others play a role in calcium homeostasis.. Newborn babies are at particular risk of vitamin K deficiency, as placental transfer is limited and human milk is a poor source. Vitamin K prophylaxis at birth effectively prevents vitamin K deficiency bleeding (VKDB), formerly known as "haemorrhagic disease of the newborn". Recent epidemiological studies provide data on the effectiveness of different administration routes and dosing schemes. Infants of mothers taking drugs that inhibit vitamin K are at risk of early VKDB and should receive 1 mg intramuscular (i.m.) as soon as possible after birth. Classic VKDB is prevented by intramuscular as well as by oral administration of 1 mg vitamin K. In exclusively breast-fed infants, single i.m. administration at birth is also effectively preventing (rare) late VKDB but single oral administration is not. If given orally, prophylaxis should be continued by either weekly administration of 1 mg till 12 weeks or repeating 2 mg at weeks 1 and 4. Daily administration of 25 microg offers insufficient protection. The only infants not fully protected in this way are those with yet unrecognised liver disease.. Further work is needed before firm recommendations can be made regarding dose in preterm infants and in patients with fat malabsorption/cholestasis or regarding the role of vitamin K in the prevention of osteoporosis.

Topics: Administration, Oral; Blood Coagulation; Breast Feeding; Calcium; Dose-Response Relationship, Drug; Drug Administration Schedule; Homeostasis; Humans; Infant, Newborn; Infant, Premature, Diseases; Injections, Intramuscular; Liver; Risk Factors; Vitamin K; Vitamin K 1; Vitamin K 2; Vitamin K Deficiency; Vitamin K Deficiency Bleeding

To determine the effect of maternal antenatal administration of vitamin K1 on activity level of vitamin K-dependent coagulation factors and on the occurrence of periventricular-intraventricular hemorrhage (PIVH).. This study was conducted on 90 infants who were classified into; Group A: 30 preterm whose mothers received antenatal vitamin K1, Group B: 30 preterm whose mothers did not receive antenatal vitamin K1, and Group C: 30 healthy full term newborns as a control group. All newborns were subjected to measurement of the activity level of vitamin K-dependent coagulation factors (FII, FVII, FIX and FX). Cranial ultrasound was done on the 1st, 3rd and 7th days of life.. Group B showed significantly lower activity level of FII and FX with higher incidence of PIVH compared with group A. Neonates who developed PIVH by the 7th day in both group A and B had significantly lower activity level of vitamin K-dependent coagulation factors.. when antenatal vitamin K1 was given to pregnant women at imminent risk of preterm labor, their preterm neonates were able to achieve a clotting status approaching that of full term neonates and are less liable to develop PIVH.

Topics: Antifibrinolytic Agents; Blood Coagulation Factors; Cerebral Hemorrhage; Delivery, Obstetric; Egypt; Female; Fetal Blood; Humans; Incidence; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Male; Pregnancy; Prenatal Exposure Delayed Effects; Vitamin K 1

Infants less than 35 weeks' gestation age are susceptible to periventricular-intraventricular hemorrhage (PIVH). This may be partially attributable to low concentrations of vitamin K-dependent coagulation factors. The purposes of this study were: (1) to determine the umbilical blood activity levels of vitamin K-dependent coagulation factors II, VII, IX and X; (2) to investigate the change in activities of these factors in premature infants' umbilical blood after prenatal administration of vitamin K1 to the mothers; and (3) to study the prophylactic effects on PIVH after maternal antenatal supplemental vitamin K1.. Pregnant women in preterm labor at less than 35 weeks of gestation were randomly selected to receive antenatal vitamin K1 10 mg per day injection intramuscularly or intravenously for 2-7 days (vitamin K1 group, n = 40), or no such treatment (control group, n = 50). At the same period, cord blood samples were collected from thirty full-term neonates to compare the factor levels with those of premature infants. Intracranial ultrasound was performed by the same sonographer to determine the presence and severity of PIVH.. The activities of vitamin K-dependent coagulation factors in umbilical blood in the control group were: factor II 25.64+/-9.49%, factor VII 59.00+/-17.66%, factor IX 24.67+/-8.88%, and factor X 30.16+/-5.02%. In full-term infants, the respective values were: factor II 36.70+/-4.88%, factor VII 64.54+/-10.62%, factor IX 30.18+/-5.69%, and factor X 34.32+/-12.63%. In vitamin K1 group these factors were: factor II 36.35+/-6.88%, factor VII 69.59+/-16.55%, factor IX 25.71+/-10.88%, and factor X 39.26+/-8.02%. The data suggest the absence of vitamin K-dependent coagulation factors in preterm infants, and antenatal supplement of vitamin K1 may increase the cord blood activity of factor II, VII and factor X (P < 0.001). In addition, the overall rates of PIVH in the vitamin K1 group and in controls were 32.4 and 52.0%, respectively (P = 0.036), and the frequency of severe PIVH was 5.0 and 20.0%, respectively (P = 0.038).. Administration of vitamin K1 to pregnant women at less than 35 weeks' gestation age may result in improved coagulation and may reduce the incidence as well as the severity degree of PIVH.

Topics: Blood Coagulation Factors; Cerebral Hemorrhage; Female; Fetal Blood; Fetal Therapies; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Pregnancy; Vitamin K 1

We prospectively evaluated whether combined antenatal corticosteroid and vitamin K administration have any benefit, over and above that of corticosteroid or vitamin K used alone, in reducing the frequency and the degree of PIVH in premature newborns less than 35 weeks' gestation. All of these 280 pregnant women were randomly allocated into five groups according to the in-patient sequence. Group A (vitamin K1 group) including 38 pregnant women (40 newborns) received antenatal intramuscular or intravenously injection of vitamin K1 10 mg per day for 2-7 days. Group B (single dose corticosteroid group) including 57 pregnant women (63 newborns) received antenatal intramuscular or intravenously injection of dexamethasone 10 mg per day for 1 day. Group C (two dose corticosteroid group) including 62 pregnant women (70 newborns) received antenatal intramuscular or intravenously injection of dexamethasone 10 mg per day for 2 days. Group D (combined using dexamethasone and vitamin K1) including 41 pregnant women (44 newborns) received dexamethasone 10 mg per day for 1 day and vitamin K110 mg per day for 2-7 days. Control group, including 82 pregnant women (87 newborns) were received neither dexamethasone nor vitamin K1 injection. The results showed PIVH was diagnosed in 17 of 40 (42.5%) in Group A, 34 of 63 (54.0%) in Group B, 36 of 70 (51.4%) in Group C, 14 of 44 (31.8%) in Group D, and 57 of 87 (65.2%) in control infants (p = 0.004). More infants in the control group had grade III or IV intracranial hemorrhage after birth (p = 0.049). After antenatal supplement of dexamethasone and vitamin K1, both the total incidence of PIVH and the frequency of severe PIVH decreased significantly. The total and severe incidence of PIVH in Group B (single doses dexamethasone) and Group C (two courses dexamethasone) there were no significant difference. It showed that after antenatal supplement of dexamethasone and vitamin K1, both the total incidence of PIVH and the frequency of severe PIVH decreased significantly, and combined antenatal corticosteroid and vitamin K administration have much benefit, over and above that of corticosteroid or vitamin K used alone.

Topics: Blood Coagulation Factors; Cerebral Hemorrhage; Dexamethasone; Female; Fetal Blood; Fetal Therapies; Glucocorticoids; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Pregnancy; Prenatal Care; Prospective Studies; Vitamin K 1

Infants less than 35 weeks of gestational age are susceptible to peri-/intraventricular hemorrhage (PIVH). This may be due in part to low concentrations of vitamin K-dependent coagulation factors. This study was conducted to determine the umbilical cord blood activities of vitamin K-dependent coagulation factors II, VII, IX and X in premature infants to understand whether preterm infants have absence status of these factors the changes of theses factors' activities in premature infants' umbilical blood after vitamin K(1) was given to mothers antenatally and the preventing effectiveness of PIVH after maternal antenatal supplement of vitamin K(1).. Pregnant women in preterm labor at less than 35 weeks of gestational age were randomly selected to receive antenatal vitamin K(1) intramuscular or intravenous injections 10 mg per day for 2 to 7 days (vitamin K(1) group), or no vitamin K(1) treatment (control group). Dexamethone was antenatally given to both groups of pregnant women routinely. Vitamin K(1) group had 44 infants and the control group had 133 infants. During the same period, thirty full-term neonates' cord blood samples were obtained to determine theses factors to compare with those from the premature infants. The cranial ultrasound was performed by a same physician to understand whether the neonates were complicated with PIVH and its severity.. The levels of vitamin K-dependent coagulation factors in umbilical blood in control group were significantly lower than those in full-term infants' cord blood (P < 0.05). However, in vitamin K(1) group, supplement of vitamin K(1) antenatally could significantly increase activities of factors II, VII and X in preterm infants' cord blood (P < 0.05). The total occurrence rates of PIVH in vitamin K(1) group and control group were 31.8% and 52.6%, respectively, (P = 0.017), and the frequency of severe PIVH in vitamin K(1) group and control group was 2.3% and 12.0%, respectively (P = 0.057).. Preterm infants have absence status of vitamin K-dependent coagulation factors. Administration of vitamin K(1) to pregnant women at less than 35 weeks of gestational age resulted in significantly improved activities of vitamin K-dependent coagulation factors II, VII, and X, and a significantly decreased frequency of PIVH and less severe hemorrhage in preterm infants.

Topics: Blood Coagulation Factors; Cerebral Hemorrhage; Female; Fetal Blood; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Pregnancy; Vitamin K 1

Topics: Anti-Bacterial Agents; Blood Coagulation Factors; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature, Diseases; Parenteral Nutrition; Parenteral Nutrition, Total; Vitamin K 1; Vitamin K Deficiency

Topics: Child; Hemorrhage; Humans; Hypoprothrombinemias; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Vitamin K; Vitamin K 1

Topics: Antifibrinolytic Agents; Hemorrhagic Disorders; Humans; Infant, Newborn; Infant, Premature, Diseases; Vitamin K; Vitamin K 1; Vitamin K Deficiency Bleeding