PIVKA-II plasma levels as markers of subclinical vitamin K deficiency in term infants.

Abstract

BACKGROUND:

As the vitamin K content of human milk is low and the newborn infant's stores of vitamin K are small, vitamin K deficiency with hemorrhage in the newborn is a worldwide problem. Proteins Induced by Vitamin K Absence (PIVKA-II) are the inactive under-γ-carboxylated forms of vitamin K-dependent clotting factors and they could be useful in predicting subclinical vitamin K deficiency (VKD).

OBJECTIVES:

To demonstrate that PIVKA-II are earlier markers of subclinical VKD than Prothrombin time (PT) in exclusively breast-fed newborns.

METHODS:

A prospective, controlled, randomized study, including 53 term newborns receiving vitamin K prophylaxis (0.5 mg i.m.) at birth, was performed. At 30 days newborns were divided into three groups (G) receiving respectively: 25 μg/die of vitamin K (G I), 12 μg/die (G II) or placebo (G III). PIVKA-II and PT were measured on 30th and 90th days of life.

RESULTS:

G III and GII showed a significant increase in PIVKA-II from 30 to 90 days of life respectively from 2.6 to 4.7 (p = 0.001) and from 2.3 to 3.5 (p < 0.001). No significant changes were found in GI. PT showed no significant changes among groups.

CONCLUSIONS:

PT is a less sensitive marker than PIVKA II. Oral supplementation with 25 μg/die avoids an increase of PIVKA-II. Despite increased PIVKA-II do not mean an impending occurrence of bleeding, they highlight a subclinical VKD and its relative risk.

• Authors: F Dituri, G Buonocore, A Pietravalle, F Naddeo, M Cortesi, P Pasqualetti, M L Tataranno, R Agostino
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 25 Issue 9 Pg. 1660-3 (Sep 2012) ISSN: 1476-4954 [Electronic] England
• PMID: 22280352 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Biomarkers
• Protein Precursors
• Vitamin K
• acarboxyprothrombin
• Prothrombin

Topics

• Asymptomatic Diseases
• Biomarkers (analysis, blood)
• Dietary Supplements
• Early Diagnosis
• Fetal Blood (chemistry)
• Humans
• Infant
• Infant, Newborn
• Protein Precursors (analysis, blood, physiology)
• Prothrombin (analysis, physiology)
• Prothrombin Time
• Term Birth (blood)
• Time Factors
• Vitamin K (administration & dosage)
• Vitamin K Deficiency (blood, diagnosis, drug therapy)