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Risk factors of acquired prothrombin complex deficiency syndrome: a case-control study

Boonchian Pansatiankul1, Sutthichai Jitapunkul

  • 1Queen Sirikit National Institute of Child Health, Department of Medical Services, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|March 4, 2009
PubMed

Insights

Maternal use of herbal medicine and low vitamin K in breast milk are risk factors for acquired prothrombin complex deficiency (APCD) in infants. Routine intramuscular vitamin K1 prophylaxis is recommended for breastfed newborns.

Area of Science:

  • Pediatrics
  • Neonatology
  • Hematology

Background:

  • Idiopathic vitamin K deficiency in infancy, or acquired prothrombin complex deficiency (APCD), is a severe bleeding disorder in infants.
  • APCD is associated with high mortality and long-term neurological deficits.
  • Low vitamin K intake is a suspected major factor in APCD pathogenesis.

Purpose of the Study:

  • To identify risk factors for acquired prothrombin complex deficiency syndrome in early infancy.

Main Methods:

  • A case-control study involved 20 infants with APCD and 60 matched controls.
  • Data collected included feeding type, maternal history of herbal medicine use, and vitamin K1 prophylaxis history.
  • Infants were breastfed, with or without formula supplementation.

Main Results:

  • Maternal use of herbal liquor extracts was significantly more common in cases (p=0.03).
  • Breast milk vitamin K2MK4 levels were lower in mothers who used herbal extracts (p=0.03).
  • Infants receiving intramuscular vitamin K1 prophylaxis were not cases; oral prophylaxis showed a higher case rate.

Conclusions:

  • Vitamin K content in breast milk plays a crucial role in APCD pathogenesis.
  • Maternal consumption of herbal liquor extracts may contribute to APCD.
  • Routine intramuscular vitamin K1 prophylaxis for all breastfed newborns is recommended; oral prophylaxis efficacy requires urgent study.
Abstract

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