Biochemical vitamin K deficiency in early infancy: diagnostic limitation of conventional coagulation tests

Area of Science:

• Biochemistry
• Pediatrics
• Hematology

Background:

• Vitamin K is essential for blood coagulation.
• Infants, especially breastfed ones, are at risk for vitamin K deficiency.
• Standard coagulation tests may not fully reflect vitamin K status.

Purpose of the Study:

• To compare coagulation parameters in breastfed versus formula-fed infants.
• To evaluate the adequacy of standard coagulation tests in detecting vitamin K deficiency.

Main Methods:

• Two groups of infants were studied: breastfed (low vitamin K diet) and formula-fed (high vitamin K regimen).
• No infant received vitamin K prophylaxis at birth.
• Thrombotest, factor II, and factor X levels were measured at 30, 60, and 90 days postpartum.

Main Results:

• Breastfed infants had lower Thrombotest values and higher factor II levels at 30 and 60 days compared to formula-fed infants.
• No significant difference in factor X levels was observed between the groups.
• Standard coagulation tests were inadequate for detecting biochemical vitamin K deficiency compared to PIVKA II measurement.

Conclusions:

• Standard coagulation tests like Thrombotest are insufficient for diagnosing vitamin K deficiency in infants.
• Biochemical assessment using methods like PIVKA II is necessary for accurate diagnosis.
• Infant feeding practices significantly impact vitamin K status and coagulation parameters.