Publication: Prevalence of subclinical vitamin K deficiency in Thai newborns: Relationship to maternal phylloquinone intakes and delivery risk
3
Issued Date
2010-03-01
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ISSN
14682052
13592998
13592998
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2-s2.0-77949836221
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Mahidol University
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SCOPUS
Bibliographic Citation
Archives of Disease in Childhood: Fetal and Neonatal Edition. Vol.95, No.2 (2010)
Suggested Citation
Ampaiwan Chuansumrit, Tassanee Plueksacheeva, Sansanee Hanpinitsak, Siwaponr Sangwarn, Suthida Chatvutinun, Umaporn Suthutvoravut, Yongyoth Herabutya, Martin J. Shearer Prevalence of subclinical vitamin K deficiency in Thai newborns: Relationship to maternal phylloquinone intakes and delivery risk. Archives of Disease in Childhood: Fetal and Neonatal Edition. Vol.95, No.2 (2010). doi:10.1136/adc.2009.173245 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/29753
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Title
Prevalence of subclinical vitamin K deficiency in Thai newborns: Relationship to maternal phylloquinone intakes and delivery risk
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Abstract
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 the maternofetal risk factors that predispose infants 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 (protein induced by vitamin K absence/antagonist-II (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 categorised 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 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=0.006). Mothers with K1 intakes below the US recommended 'adequate intake' for pregnancy (<90 μg/day) 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.