Vitamin K prophylaxis for preterm infants

Clarke, Paul

doi:10.1016/j.earlhumdev.2010.01.013

Cited by 28 publications

(21 citation statements)

References 29 publications

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“…This drug is then continued with 2 mg once a week regardless of gestational age and weight for neonates feeding on breast milk. Although there is a consensus on the fact that all premature infants should receive phytomenadione, neonatologists use a variety of doses, routes of administrations and formulations . To date, few studies have been carried out to refine vitamin K dosage, efficacy or duration of treatment or to assess vitamin K status after prophylaxis.…”

Section: Demographic and General Prescriptions Characteristicsmentioning

confidence: 99%

Unlicensed and off‐label drug use: a prospective study in French NICU

et al. 2015

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Section: Demographic and General Prescriptions Characteristicsmentioning

confidence: 99%

Unlicensed and off‐label drug use: a prospective study in French NICU

et al. 2015

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“…Vitamin K is a fat-soluble vitamin given to both term and preterm infants to prevent bleeding due to known deficiency at birth, although the dose provided in preterm infants may vary up to 20-fold (Clarke, 2010). We have previously shown that vitamin K can prevent oxidative injury to undifferentiated oligodendrocytes (Li et al, 2003).…”

Section: Potential Role Of Nutritionmentioning

confidence: 99%

The challenge of understanding cerebral white matter injury in the premature infant

Elitt

Rosenberg

2014

Neuroscience

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White matter injury in the premature infant leads to motor and more commonly behavioral and cognitive problems that are a tremendous burden to society. While there has been much progress in understanding unique vulnerabilities of developing oligodendrocytes over the past 30 years, there remain no proven therapies for the premature infant beyond supportive care. The lack of translational progress may be partially explained by the challenge of developing relevant animal models when the etiology remains unclear, as is the case in this disorder. There has been an emphasis on hypoxia-ischemia and infection/inflammation as upstream etiologies, but less consideration of other contributory factors. This review highlights the evolution of white matter pathology in the premature infant, discusses the prevailing proposed etiologies, critically analyzes a sampling of common animal models and provides detailed support for our hypothesis that nutritional and hormonal deprivation may be additional factors playing critical and overlooked roles in white matter pathology in the premature infant.

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“…Infants were randomly allocated to receive one of the following doses of Konakion Neonatal vitamin K 1 : 200 g i.m., 500 g i.m., or 200 g i.v. Because preterm infants are potentially at increased risk of VKDB (13,20), vitamin K prophylaxis was not delayed. We aimed to collect all urine voided in the first week of life, but at least for 48 h after vitamin K 1 administration.…”

Section: Subjectsmentioning

confidence: 99%

“…In particular, preterm infants are potentially exposed to high tissue concentrations of vitamin K through the adoption of prophylaxis regimens initially intended for term infants and from addition of excessive vitamin K to parenteral nutrition feeds (11)(12)(13). The reported association between i.m.…”

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Urinary Excretion of Vitamin K Metabolites in Term and Preterm Infants: Relationship to Vitamin K Status and Prophylaxis

et al. 2010

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ABSTRACT:Little is known about the metabolic turnover and excretion of vitamin K in healthy newborn infants and the metabolic consequences of prophylactic regimens designed to protect against vitamin K deficiency bleeding (VKDB). We measured the excretion of two urinary metabolites (Յ24 h) of vitamin K (5C-and 7C-aglycones) in term infants before (n ϭ 11) and after (n ϭ 5) a 1000 g i.m. dose of vitamin K 1 (K 1 ) and in preterm infants after 200 g i.m. (n ϭ 4), 500 g i.m. (n ϭ 4), or 200 g i.v. (n ϭ 5). In preterm infants, we also measured serum K 1 , vitamin K 1 2,3-epoxide, and PIVKA-II at 5 d postpartum. Before prophylaxis, the rate of 5C-and 7C-aglycone excretion was 25 times lower than adults, reflecting low vitamin K stores at birth. After prophylaxis, the excretion rate correlated to K 1 dose (r ϭ 0.6) but was two orders of magnitude lower than that in adults, probably reflecting the immaturity of neonatal catabolism. All term and 10 of 13 preterm infants mainly excreted 5C-aglycone. We present evidence that increased excretion of the 7C-aglycone was associated with metabolic overload because of the exposure to high-tissue K 1 concentrations. Measurement of the 5C-and 7C-aglycones may facilitate longitudinal studies of vitamin K status in neonates and aid the development of improved prophylactic regimens. (Pediatr Res 68: 508-512, 2010)

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Vitamin K prophylaxis for preterm infants

Cited by 28 publications

References 29 publications

Unlicensed and off‐label drug use: a prospective study in French NICU

Unlicensed and off‐label drug use: a prospective study in French NICU

The challenge of understanding cerebral white matter injury in the premature infant

Urinary Excretion of Vitamin K Metabolites in Term and Preterm Infants: Relationship to Vitamin K Status and Prophylaxis

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