scholarly journals Vitamin K Deficiency Bleeding in Infancy

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 780
Author(s):  
Shunsuke Araki ◽  
Akira Shirahata
Keyword(s):  
Oral Administration ◽  
Vitamin K ◽  
Placental Transfer ◽  
Late Onset ◽  
Newborn Infants ◽  
Coagulation Factors ◽  
Epidemiological Studies ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
K Deficiency

Vitamin K is essential for the synthesis of few coagulation factors. Infants can easily develop vitamin K deficiency owing to poor placental transfer, low vitamin K content in breast milk, and poor intestinal absorption due to immature gut flora and malabsorption. Vitamin K deficiency bleeding (VKDB) in infancy is classified according to the time of presentation: early (within 24 h), classic (within 1 week after birth), and late (between 2 week and 6 months of age). VKDB in infancy, particularly late-onset VKDB, can be life-threatening. Therefore, all infants, including newborn infants, should receive vitamin K prophylaxis. Exclusive breastfeeding and cholestasis are closely associated with this deficiency and result in late-onset VKDB. Intramuscular prophylactic injections reduce the incidence of early-onset, classic, and late-onset VKDB. However, the prophylaxis strategy has recently been inclined toward oral administration because it is easier, safer, and cheaper to administer than intramuscular injection. Several epidemiological studies have shown that vitamin K oral administration is effective in the prevention of VKDB in infancy; however, the success of oral prophylaxis depends on the protocol regimen and parent compliance. Further national surveillance and studies are warranted to reveal the optimal prophylaxis regimen in term and preterm infants.

Rise in Late Onset Vitamin K Deficiency Bleeding in Young Infants Because of Omission or Refusal of Prophylaxis at Birth

2014 ◽  
Vol 50 (6) ◽  
pp. 564-568 ◽  
Author(s):  
Rachael Schulte ◽  
Lori C. Jordan ◽  
Anna Morad ◽  
Robert P. Naftel ◽  
John C. Wellons ◽  
...  
Keyword(s):  
Vitamin K ◽  
Late Onset ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
Young Infants ◽  
K Deficiency

scholarly journals Late vitamin K deficiency bleeding despite intramuscular prophylaxis at birth - is there a need for additional supplementation?

2017 ◽  
Vol 145 (5-6) ◽  
pp. 254-258 ◽  
Author(s):  
Jelena Martic ◽  
Katarina Pejic ◽  
Dobrila Veljkovic ◽  
Zorica Rakonjac ◽  
Milos Kuzmanovic ◽  
...  
Keyword(s):  
Vitamin K ◽  
Tertiary Care ◽  
Newborn Infants ◽  
Antibiotic Use ◽  
Daily Weight Gain ◽  
Vitamin K1 ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
Breastfed Infants ◽  
K Deficiency

Introduction/Objective. Vitamin K deficiency is common in newborn infants and without prophylaxis there is a risk of vitamin K deficiency bleeding (VKDB). The most frequent prophylactic approach is an intramuscular (IM) injection of vitamin K1 immediately after birth. Its efficiency to prevent late VKDB has been recently questioned by several reports. Based on our experience, we discuss the need for additional vitamin K1 supplementation after its IM administration at birth. Methods. We present a retrospective review of 12 infants, 11 with confirmed and one with probable late VKDB despite IM prophylaxis at birth, who were treated in the two largest tertiary care pediatric hospitals in Serbia during the last 15 years. Results. All the patients were exclusively breastfed. In 11 patients, daily weight gain was normal or increased, and one patient had failure to gain weight. Six infants were previously healthy, three infants received antibiotics prior to bleeding, and in two diarrhea and cholestasis, respectively, existed previously. An intracranial bleeding was documented in nine infants, four of whom died. Conclusion. Low content of phytomenadione in human milk could occasionally be attributed to late VKDB despite postnatal IM injection of vitamin K1 in otherwise healthy, exclusively breastfed infants. This might be aggravated by transient disturbance of vitamin K turnover due to antibiotic use, acute diarrhea, or transient cholestasis. We suggest that an additional vitamin K1 supplementation after postnatal IM prophylaxis could be justified in exclusively breastfed infants.

scholarly journals Prevention of Vitamin K Deficiency Bleeding in Newborn Infants

2016 ◽  
Vol 63 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Walter A. Mihatsch ◽  
Christian Braegger ◽  
Jiri Bronsky ◽  
Cristina Campoy ◽  
Magnus Domellöf ◽  
...  
Keyword(s):  
Vitamin K ◽  
Newborn Infants ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
K Deficiency

Late-Onset Vitamin K Deficiency Bleeding

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Carlos I. Higuera-Cetina ◽  
Lina M. Montaña-Gómez ◽  
Yelson A. Picón-Jaimes ◽  
Javier E. Orozco-Chinome ◽  
Ivan D. Lozada-Martínez ◽  
...  
Keyword(s):  
Vitamin K ◽  
Late Onset ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
K Deficiency

Placental Transfer of Vitamin K1 and Its Implications in Fetal Hemostasis

1988 ◽  
Vol 60 (01) ◽  
pp. 039-043 ◽  
Author(s):  
L Mandelbrot ◽  
M Guillaumont ◽  
M Leclercq ◽  
J J Lefrère ◽  
D Gozin ◽  
...  
Keyword(s):  
Vitamin K ◽  
High Performance ◽  
Ultrasound Guidance ◽  
Placental Transfer ◽  
Vitamin K1 ◽  
Vitamin K Deficiency ◽  
Prothrombin Activity ◽  
Oral Supplementation ◽  
K Deficiency ◽  
The Mean

SummaryVitamin K status was evaluated using coagulation studies and/ or vitamin IQ assays in a total of 53 normal fetuses and 47 neonates. Second trimester fetal blood samples were obtained for prenatal diagnosis under ultrasound guidance. Endogenous vitamin K1 concentrations (determined by high performance liquid chromatography) were substantially lower than maternal levels. The mean maternal-fetal gradient was 14-fold at mid trimester and 18-fold at birth. Despite low vitamin K levels, descarboxy prothrombin, detected by a staphylocoagulase assay, was elevated in only a single fetus and a single neonate.After maternal oral supplementation with vitamin K1, cord vitamin K1 levels were boosted 30-fold at mid trimester and 60 fold at term, demonstrating placental transfer. However, these levels were substantially lower than corresponding supplemented maternal levels. Despite elevated vitamin K1 concentrations, supplemented fetuses and neonates showed no increase in total or coagulant prothrombin activity. These results suggest that the low prothrombin levels found during intrauterine life are not due to vitamin K deficiency.

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