Maternal antenatal administration of vitamin K1 results in increasing the activities of vitamin K-dependent coagulation factors in umbilical blood and in decreasing the incidence rate of periventricular-intraventricular hemorrhage in premature infants
-
Jing Liu
Abstract
Aims: 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.
Methods: 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.
Results: 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).
Conclusions: 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.
References
1 Al-Shawaf EM, SA Al-Alaiyan, AY Aqeel: The use of indomethacin for the prevention of intracranical brain hemorrhage in high-risk neonates. Saudi Med J21 (2000) 274Search in Google Scholar
2 Amato M, H Howald, G Von Muralt: Incidence of peri-intraventricular hemorrhage in premature neonates weighing more than 1500 g. J Perinat Med15 (1987) 91Search in Google Scholar
3 Bandstra ES, BM Montalvo, RN Goldberg: Prophylactic indomethacin for the prevention of intracranical hemorrhage in preterm infants. Pediatrics82 (1988) 533Search in Google Scholar
4 Chiswick M, G Gladman, S Sinba: Vitamin E supplementation and periventricular hemorrhage in the newborn. Am J Clin Nutr53(1 suppl) (1991) 370s10.1093/ajcn/53.1.370SSearch in Google Scholar PubMed
5 Crowther CA, DJ Henderson-Smart: Phenobarbital prior to preterm birth for preventing neonatal periventricular haemorrhage. Cochrane Database Syst Rev 3 (2003) CD00016410.1002/14651858.CD000164Search in Google Scholar PubMed
6 De Lia JE, D Billman: Antepartum vitamin K and phenobarbital for preventing intracranical hemorrhage in the premature newborn: a randomized, double blind, placebo-controlled trial. Obstet Gynecol83 (1994) 1067Search in Google Scholar
7 Donn SM, DW Roloff, GW Goldstein: Prevention of intraventricular hemorrhage in preterm infants by phenobarbitone. A controlled trial. Lancet2 (1981) 215Search in Google Scholar
8 Gleissner M, G Jorch, S Avebarius: Risk factors for intraventricular hemorrhage in a birth cohort of 3721 premature infants. J Perinat Med28 (2000) 104Search in Google Scholar
9 Habigan WC, G Kennedy, F Roemisch, et al.: Administration of indomethacin for the prevention of periventricular- intracranical hemorrhage in high-risk neonates. J Pediatr112 (1988) 941Search in Google Scholar
10 Jakobi P, A Weissman, EZ Zimmer: Survival and long-term morbidity in preterm infants with and without a clinical diagnosis of periventricular, intraventricular hemorrhage. Eur J Obstet Gynecol Reprod Biol46 (1992) 73Search in Google Scholar
11 Kazzi NJ, NB Ilang, GM Liang: Maternal administration of vitamin K does not improve the coagulation profile of preterm infants. Pediatrics84 (1989) 1045Search in Google Scholar
12 Liu J, JW He, Q Wang: The incidence of periventricular-intraventricular hemorrhage in preterm infants and its high-risk factors. Zhonghua Er Ke Za Zhi43 (2005) 216Search in Google Scholar
13 Lowe J, L Papile: Neurodevelopmental performance of very-low-birth weight infants with mild periventricular, intraventricular hemorrhage. Outcome at 5 to 6 years of age. Am J Dis Child144 (1990) 1242Search in Google Scholar
14 Ment LR, W Oh, RA Ehrenkranz: Antenatal steroids, delivery mode, and intraventricular hemorrhage in preterm infants. Am J Obstet Gynecol172 (1995) 795Search in Google Scholar
15 Morales WJ, JL Angel, UF O'Brien: The use of antenatal vitamin K in the prevention of early neonatal intraventricular hemorrhage. Am J Obstet Gynecol159 (1988) 774Search in Google Scholar
16 Papile LA, J Burstein, R Burstein: Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 gm. J Pediatr92 (1978) 529Search in Google Scholar
17 Pietersma-de Bruyn AL, PJ van der Straaten: Vitamin K1 levels and K1-dependent coagulation factors α and ι in preterm and small-for-date neonates. Eur J Pediatr149 (1990) 640Search in Google Scholar
18 Pomerance JJ, JG Teal, JF Gogolok: Maternaly administered antenatal vitamin K1: effect on neonatal prothrombin activity, partial thromboplastin time, and intraventricular hemorrhage. Obstet Gynecol70 (1987) 235Search in Google Scholar
19 Schulte J, J Osborne, JW Benson: Developmental outcome of the use of etamsylate for prevention of periventricular hemorrhage in a randomized controlled trial. Arich Dis Child Fetal Neonatal Ed90 (2005) F3110.1136/adc.2003.035790Search in Google Scholar PubMed PubMed Central
20 Sinha S, J Davies, N Toner: Vitamin E supplementation reduces frequency of periventricular hemorrhage in very preterm babies. Lancet1 (1987) 466Search in Google Scholar
21 Thorp JA, D Ferrette-Smith, LA Gaston: Combined antenatal vitamin K and phenobarbital therapy for preventing intracranical hemorrhage in newborns less than 34 weeks' gestation. Obstet Gynecol86 (1995) 1Search in Google Scholar
22 Van de Bor M, E Briet, F Van Bel: Hemostasis and periventricular-intraventricular hemorrhage of the newborn. Arch Dis Child140 (1986) 1131Search in Google Scholar
23 Van de Bor M, L den Ouden: School performance in adolescents with and without periventricular-intraventricular hemorrhage in the neonatal period. Semin Perinatal28 (2004) 295Search in Google Scholar
24 Whitelaw A: Postnatal phenobarbitone for the prevention of intraventricular hemorrhage in preterm infants. Cochrane Database Syst Rev 1 (2001) CD00169110.1002/14651858.CD001691Search in Google Scholar PubMed
25 Yang YM, N Simon, P Maertens, et al.: Maternal-fetal transport of vitamin K1 and its effects on coagulation in premature infants. J Pediatr115 (1989) 1009Search in Google Scholar
©2005 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Intrapartum fetal monitoring today
- Placental Doppler velocimetry in gestational diabetes mellitus
- Induction of labor with oral misoprostol in nulliparous mothers of twins
- Is the nausea and vomiting of early pregnancy really feto-protective?
- Tele-virtual sonography
- The effect of betamethasone administration on uterine motility in pregnancy. A prospective study using four-channel tocography
- Perinatal outcomes of spontaneous twins compared with twins conceived through intracytoplasmic sperm injection
- Doppler sonography of the uterine and the cubital arteries in normal pregnancies, preeclampsia and intrauterine growth restriction: evidence for a systemic vessel involvement
- The efficacy of first-trimester PAPP-A and free βhCG levels for predicting adverse pregnancy outcome
- Sonographic monitoring of systemic and local methotrexate (MTX) therapy in patients with intact interstitial pregnancies
- The Northwestern twin chorionicity study: testing the ‘placental crowding’ hypothesis
- Combined first trimester screening for trisomy 21: lack of agreement between risk calculation methods
- Neonatal septicemia in high risk babies in South-Eastern Nigeria
- Maternal antenatal administration of vitamin K1 results in increasing the activities of vitamin K-dependent coagulation factors in umbilical blood and in decreasing the incidence rate of periventricular-intraventricular hemorrhage in premature infants
- Antenatal diagnosis of velocardiofacial syndrome by 3D ultrasonography
- Congress Calendar
Articles in the same Issue
- Intrapartum fetal monitoring today
- Placental Doppler velocimetry in gestational diabetes mellitus
- Induction of labor with oral misoprostol in nulliparous mothers of twins
- Is the nausea and vomiting of early pregnancy really feto-protective?
- Tele-virtual sonography
- The effect of betamethasone administration on uterine motility in pregnancy. A prospective study using four-channel tocography
- Perinatal outcomes of spontaneous twins compared with twins conceived through intracytoplasmic sperm injection
- Doppler sonography of the uterine and the cubital arteries in normal pregnancies, preeclampsia and intrauterine growth restriction: evidence for a systemic vessel involvement
- The efficacy of first-trimester PAPP-A and free βhCG levels for predicting adverse pregnancy outcome
- Sonographic monitoring of systemic and local methotrexate (MTX) therapy in patients with intact interstitial pregnancies
- The Northwestern twin chorionicity study: testing the ‘placental crowding’ hypothesis
- Combined first trimester screening for trisomy 21: lack of agreement between risk calculation methods
- Neonatal septicemia in high risk babies in South-Eastern Nigeria
- Maternal antenatal administration of vitamin K1 results in increasing the activities of vitamin K-dependent coagulation factors in umbilical blood and in decreasing the incidence rate of periventricular-intraventricular hemorrhage in premature infants
- Antenatal diagnosis of velocardiofacial syndrome by 3D ultrasonography
- Congress Calendar
