RSS-Feed abonnieren
DOI: 10.1055/s-2003-45384
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662
Vitamin K Prophylaxis for Premature Infants: 1 mg versus 0.5 mg
Publikationsverlauf
Publikationsdatum:
02. Januar 2004 (online)
![](https://www.thieme-connect.de/media/ajp/200308/lookinside/thumbnails/10.1055-s-2003-45384-1.jpg)
ABSTRACT
We studied babies (22 to 32 weeks gestational age) of mothers wishing to breast-feed. Group 1 received 1 mg of vitamin K and Group 2 received 0.5 mg of vitamin K. The Day 2 plasma levels of vitamin K were 1900 to 2600 times higher on average, and the Day 10 vitamin K levels 550 to 600 times higher on average, relative to normal adult plasma values, whether an initial prophylaxis dose of 0.5 mg or 1 mg was used. We conclude that 0.5 mg as the initial dose of vitamin K intramuscularly or intravenously would likely be more than adequate to prevent hemorrhagic disease of the newborn, and that 0.3 mg/per kg may be used for babies with birth weights below 1000 g. To decrease vitamin K intakes in this population, new preparations of total parenteral nutrition multivitamins are needed.
KEYWORDS
Vitamin K - premature babies - total parenteral nutrition
REFERENCES
- 1 Israels L G, Israels E D, Saxena S P. The riddle of vitamin K1 deficit in the newborn. Semin Perinatol . 1997; 21 90-96
- 2 Tsaioun K I. Vitamin K-dependent proteins in the developing and aging nervous system. Nutr Rev . 1999; 57 231-240
- 3 Greer F R. Are breast-fed infants vitamin K deficient?. In: Newburg D, ed. Bioactive Components of Human Milk. New York: Kluwer Academic/Plenum Publishers 2001 : 391-395
- 4 Greer F R, Marshall S P, Severson R R. et al . A new mixed micellar preparation for oral vitamin K prophylaxis: randomised controlled comparison with an intramuscular formulation in breast fed infants. Arch Dis Child . 1998; 79 300-305
- 5 Tyson J E. Immediate care of the newborn infant. In: Sinclair JC, Bracken MB, eds. Effective Care of the Newborn Infant Oxford: Oxford University Press 1992: 25
- 6 Greer F R, Mummah-Schendel L L, Marshall S, Suttie J W. Vitamin K1 and vitamin K2 status in the newborn during the first week of life. Pediatrics . 1988; 81 137-140
- 7 Kumar D, Greer F R, Super D M, Suttie J W, Moore J J. Vitamin K status of premature infants: implications for current recommendations. Pediatrics . 2001; 108 1117-1122
- 8 Ferland G. The vitamin K-dependent proteins: an update. Nutr Rev . 1998; 56 223-230
- 9 Saxena S P, Israels E D, Israels L G. Novel vitamin K-dependent pathways regulating cell survival. Apoptosis . 2001; 6 57-68
- 10 Greer F R, Costakos D T, Suttie J W. Determination of des-gamma-carboxy-prothrombin (PIVKA II) in cord blood of various gestational ages with the STAGO antibody: a market of vitamin K deficiency (Abstract 1667)?. Pediatr Res . 1999; 45 283A
- 11 McCarthy P T, Harrington D J, Shearer M J. Assay of phylloquinone in plasma by HPLC with electrochemical detection. Methods Enzymol . 1997; 282 421-435
- 12 Shearer M J. Phylloquinone (vitamin K1) in serum or plasma by HPLC. In: Fidanza F, ed. Nutritional Status Assessment: A Manual for Population Studies London: Chapman & Hall 1991: 214-220
- 13 Papile L A, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr . 1978; 92 529-534
- 14 Loughnan P M, McDougall P N, Balvin H, Doyle L W, Smith A L. Late onset haemorrhagic disease in premature infants who received intravenous vitamin K1. J Paediatr Child Health . 1996; 32 268-269
- 15 Raith W, Fauler G, Pichler G, Muntean W. Plasma concentrations after intravenous administration of phylloquinone (vitamin K1) in preterm and sick neonates. Thromb Res . 2000; 99 467-472
- 16 American Academy of Pediatrics. Nutritional needs of preterm infants. In: Kleinman RE, ed. Pediatric Nutrition Handbook 4th ed. Elk Grove, IL: American Academy of Pediatrics 1998: 66-68
- 17 Net NICU. Survey conducted May 18, 2003 via electronic listserve with 800 members of the international neonatology community [personal communication].
- 18 Schanler R J. Current status of vitamin A and E supplementation in the extremely low birth weight infant. In: Hansen TN, McIntosh N, eds. Current Topics in Neonatology London: WB Saunders 2000: 44-71
- 19 Davidson R T, Foley A L, Engelke J A, Suttie J W. Conversion of dietary phylloquinone to tissue menaquinone-4 in rats is not dependent on gut bacteria. J Nutr . 1998; 128 220-223
- 20 Pauli R M, Madden J D, Kranzier K J. et al . Warfarin therapy initiated during pregnancy and phenotypic chondrodysplasia punctata. J Pediatr . 1976; 88 506-508
- 21 Hall J G, Pauli R M, Wilson K M. Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med . 1980; 68 122-140
-
22 Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A: Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academies Press; 2002: 162-189
- 23 Greer F R. Vitamin K in nutritional needs of the preterm infant: scientific basis and practical guidelines. In: Tsang RC, Lucas A, Uauy R, Zlotkin S, eds. Nutritional Needs of the Preterm Infant: Scientific Basis and Practical Guidelines Baltimore: Williams & Wilkins 1993: 111-119