Intraventricular Hemorrhage Due to Coagulopathy After Vitamin K Administration in a Preterm Infant With Maternal...

Area of Science:

• Neonatal Medicine
• Hematology
• Obstetrics

Background:

• Intraventricular hemorrhage (IVH) is a significant cause of morbidity in preterm infants, often leading to poor neurodevelopmental outcomes.
• Post-acute-phase IVH, occurring more than one week after birth, is an uncommon clinical presentation.
• Neonatal hemostasis is immature and further compromised by prematurity, increasing bleeding risks.

Observation:

• A preterm infant developed intraventricular hemorrhage (IVH) beyond the typical acute phase (>1 week post-birth).
• The infant's mother had active Crohn disease during pregnancy, leading to maternal malnutrition and potential vitamin K deficiency.
• Despite vitamin K administration, the infant presented with coagulopathy and late-onset IVH.

Findings:

• Maternal Crohn disease can precipitate fetal vitamin K deficiency due to malabsorption.
• Severe coagulopathy, potentially linked to vitamin K deficiency, can be a critical factor in intraventricular hemorrhage development.
• This case demonstrates a rare instance of post-acute-phase IVH in a preterm infant linked to maternal Crohn disease and coagulopathy.

Implications:

• Highlights the importance of assessing maternal health conditions, such as Crohn disease, for fetal bleeding risks.
• Suggests that standard vitamin K prophylaxis may be insufficient in cases of severe maternal-induced coagulopathy.
• Emphasizes the need for vigilant monitoring and tailored management strategies for preterm infants at risk for late-onset IVH.