Related Experiment Videos
Effect of a reduced vitamin K supplementation on prothrombin time in prematures and high-risk neonates
R Rossi1, O Albrecht, H Pollmann
1University Children's Hospital, Münster, Germany.
Insights
New vitamin K supplementation guidelines for neonates were evaluated. Reduced doses maintained safe prothrombin times (PT) in most infants, suggesting current recommendations are effective for preventing vitamin K deficiency bleeding.
Area of Science:
- Neonatal Medicine
- Pediatric Pharmacology
- Hematology
Background:
- Recent changes in vitamin K supplementation guidelines for neonates.
- Established recommendations include 3 x 1 mg orally for term neonates and 0.2 mg parenterally for premature and high-risk infants.
- Vitamin K deficiency bleeding is a concern in newborns.
Purpose of the Study:
- To assess the efficacy of reduced vitamin K doses in neonates.
- To evaluate prothrombin times (PT) in infants receiving lower vitamin K supplementation.
- To determine if reduced vitamin K regimens maintain adequate hemostasis.
Main Methods:
- Prospective study of 120 patients with 170 prothrombin time (PT) samples.
- Analysis of PT levels during the first 6 weeks of life.
- Correlation of PT with birthweight, gestational age, and infant age.
Main Results:
- Only 6 patients had PT below 40%, unrelated to vitamin K dose.
- Median PT was 100%, with 79% of patients above 70%.
- PT levels were influenced by birthweight, gestational age, and age, but showed no decrease over time.
Conclusions:
- Reduced oral and parenteral vitamin K regimens resulted in prothrombin times within established reference values.
- The current reduced vitamin K supplementation appears effective in maintaining adequate hemostasis in neonates.
- These findings support the recent changes in vitamin K dosing recommendations.
Abstract:
Recommendations for vitamin K supplementation were recently changed to 3 x 1 mg orally in healthy term neonates and 0.2 mg parenterally in prematures and high-risk neonates. Prothrombin times (PT) at reduced vitamin K doses (120 patients, 170 samples) during the first 6 weeks of life were below 40% in 6 patients only; all low PTs were unrelated to vitamin K. In the remaining patients, median PT was 100%; 79% of patients had values above 70%. PT was related to birthweight, gestational age and age. There was no decrease over the observation period. Following reduced oral and parenteral vitamin K regimens PTs were well within published reference values for neonates given larger amounts of vitamin K.