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Effect of vitamin K administration on acarboxy prothrombin (PIVKA-II) levels in newborns
Insights
Vitamin K prophylaxis at birth significantly reduces PIVKA-II levels in newborns. Protein induced by vitamin K absence or antagonist-II (PIVKA-II) monitoring may offer a better assessment of vitamin K status than coagulation tests.
Area of Science:
- Biochemistry
- Neonatal Medicine
- Pediatric Hematology
Background:
- Neonatal vitamin K deficiency can lead to bleeding disorders.
- Vitamin K administration at birth is a standard prophylactic measure.
- Protein induced by vitamin K absence or antagonist-II (PIVKA-II) is a marker of vitamin K deficiency.
Purpose of the Study:
- To evaluate the efficacy of prophylactic vitamin K in reducing PIVKA-II levels in newborns.
- To compare PIVKA-II levels with traditional coagulation tests for assessing vitamin K status in neonates.
- To determine if PIVKA-II levels can predict response to vitamin K treatment.
Main Methods:
- Measurement of PIVKA-II levels in two groups of newborns: one receiving vitamin K at birth, and an untreated control group.
- Assessment of PIVKA-II positivity at 3 and 5 days of age.
- Administration of vitamin K to newborns with low normotest levels (<30%) and monitoring of response.
Main Results:
- The untreated group showed a significantly higher proportion of PIVKA-II positive newborns at 3 and 5 days compared to the treated group.
- Newborns with higher pre-treatment PIVKA-II levels demonstrated a greater response to vitamin K, as indicated by normotest levels.
- PIVKA-II levels may be a more sensitive indicator of vitamin K status than coagulation tests, especially in cases of immature factor production.
Conclusions:
- Prophylactic vitamin K administration at birth is effective in preventing elevated PIVKA-II levels in newborns.
- PIVKA-II monitoring offers a potentially more accurate assessment of vitamin K status in neonates than conventional coagulation tests.
- These findings support the routine use of vitamin K prophylaxis to prevent neonatal bleeding.
Abstract:
PIVKA-II (protein induced by vitamin K absence or antagonist-II) was measured in two groups of newborns, one group being given 5 mg vitamin K at birth and the other untreated. The untreated group had a significantly higher proportion of PIVKA-II positive babies at 3 and 5 days of age than did the treated group. When vitamin K was administered to newborn babies whose normotest levels were less than 30%, it was found that the higher the pre-treatment PIVKA-II levels the greater the response to vitamin K, as monitored by the normotest. Thus PIVKA-II levels might be more useful than a coagulation test, since the low activity of vitamin K dependent coagulation factors sometimes reflects not vitamin K deficiency but impaired production of these factors because of immaturity. The findings support the view that vitamin K given prophylactically at birth will help to prevent neonatal bleeding.