Comparison of the effect of oral multiple dose with single intramuscular vitamin K1 administration on prothrombin time in term baby
Abstract
Background Vitamin K deficiency can cause bleeding disorders inhealthy breastfed infants. The efficacy of newborn intramuscular
vitamin K prophylaxis for the prevention of this bleeding problem
has been well established, but this is an invasive procedure. Oral
vitamin K prophylaxis is more effective, less expensive, and less
traumatic than intramuscular administration.
Objective To compare prothrombin time (PT) after the
administration of oral multiple dose vitamin K1 with that after
an intramuscular preparation.
Methods Infants were randomised at birth into the intramuscular
(IM) group (1 mg vitamin K1) and the oral group (2 mg given at
birth and repeated at day 3). PT was monitored before and after
the administration of vitamin K1.
Results Thirty six of 70 infants received oral vitamin K1. Mean
PT (SO) before vitamin K1 administration was 36.34 (SO 20.03)
seconds in oral group and 31.96 (SO 25.51) seconds in IM group, PT changes after vitamin K1 administration were 16.29 (SO 15.46) seconds in oral group and 11.58 (SO 10.62) seconds in IM group, it did not differ significantly (P=0.203).
Conclusion Prothrombin time changes are not significantly
different between oral vitamin K1 and IM group.
References
edition. Edinburgh: Churchill, 1999; p. 798-9.
2. American Academy of Pediatric, Committee on Fetus and
Newborn. Controversies concerning vitamin K and the
newborn. Pediatrics. 2003;112:191-2
3. Lubis B. Therapy and prophylaxis of vitamin K. In: Garna H,
Nataprawira HMD, editors. Proceedings of the 13th National
Congress of Child Health, KONIKA XIII. Bandung: Small
& Smart, 2005; p. 302-6.
4. Greer FR, Marshall SP, Severson RR, Smith DA, Shearer MJ,
Pace DG, et al. A new mixed micellar preparation for oral
vitamin K prophylaxis: randomized controlled comparison
with an intramuscular formulation in breast fed infants. Arch
Dis Child. 1998;79:300-5.
5. McNinch A W, Upton C, Samuels M, Shearer MJ, McCarthy
P, Tripp JH, et al. Plasma concentrations after oral or
intramuscular vitamin Kl in neonates. Arch Dis Child.
1985;60:814-8.
6. Danielsson N, Hoa DP, Thang NV, Vos T, Loughman PM.
Intracranial haemorrhage due to late onset vitamin K
deficiency bleeding in Hanoi province, Vietnam. Arch Dis
Child Fetal Neonatal Ed. 2004;89:546-50.
7. Andrew M. Developmental hemostasis: relevans to newborn
and infants. In: Nathan GD, Orkin SH. Hematology of
infancy and childhood, editor. 5th Edition. Philadelphia:
Saunders, 1998; p. 134-4.
8. von Kries R, Hachmeister A, Gobel U. Oral mixed micellar
vitamin K for prevention oflate vitamin K deficiency bleeding.
Arch Dis Child Fetal Neonatal Ed. 2003;88: 109-12
9. von Kries R, Hachmeister A, Gobel U. Repeated oral vitamin
K prophylaxis in West Germany: acceptance and efficacy.
BMJ. 1995;310:1097-8
10. Puckett RM, Offringa M. Prophylactic vitamin K for vitamin
K deficiency bleeding in neonates (Cochrane Review). In: The
Cochrane Library. Chichester UK: John Wiley & Sons; 2004.
11. Croucher C, Azzopardi D. Compliance with recommendations
for giving vitamin K to newborn infants. BMJ. 1994;308:894-5
12. Ansell P, Roman E, Fear NT, Renfrew MJ. Vitamin K
policies and midwifery practice questionnaire survey. BMJ.
2001;322:1148-52
13. LilleymanJS, Hann IM, Blanchette VS. Hemostatic problem
in the neonate. In: Pediatric Hematology, editors. 2nd edition.
London: Churchill, 2000; p. 662-3.
14. Cornelissen EA, Kollee LA, de Abreu RA, van Baal JM,
Motohara K, Verbruggen B, et al. Effects of oral and
intramuscular vitamin K prophylaxis on vitamin K 1, PIVKAII,
and clotting factors in breast fed infants. Arch Dis Child.
1992; 67:1250-4.
15. Crowther MA, Douketis JD, Schnurr T, Steidl L, Mera V,
Ultori C, et al. Oral vitamin K lowers the international
normalized ratio more rapidly than subcutaneous vitamin K
in the treatment of warfarin-associated coagulopathy. Ann
Intern Med. 2002; 137:251-4
16. Wariyar U, HiltonS, Pagan J, Tin W, Hey E. Six experience of
prophylactic oral vitamin k. Arch Dis Child Fetal Neonatal
Ed. 2000; 82:64-8
17. von Kries R, Hachmeister A, Gobel U. Oral mixed micellar
vitamin K for prevention oflate vitamin K deficiency bleeding.
Arch Dis Child Fetal Neonatal Ed. 2003; 88:109-12
18. Pereira SP, Shearer MJ, Williams R, Mieli-Vergani G.
Intestinal absorption of mixed micellar phylloquinone
(vitamin K1) is unreliable in infants with conjugated
hyperbilirubinemia: implications for oral prophylaxis of
vitamin K deficiency bleeding. Arch Dis Child Fetal Neonatal
Ed. 2003;88:113-8.
19. Victoria CG, van Haecke P. Vitamin K prophylaxis in
less developed countries: policy issues and relevance
to breastfeeding promotion. Am J Public Health. 1998;88:203-9
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Accepted 2016-09-11
Published 2009-10-31