מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – At 2 weeks of age, premature infants have high plasma vitamin K levels because of supplementation, according to a report in the November issue of Pediatrics. The authors suggest that "consideration should be given to reducing the amount of parenteral vitamin K supplementation in the first few weeks of life in premature infants."
Dr. Deepak Kumar, of MetroHealth Medical Canter, Cleveland, Ohio, and colleagues measured plasma vitamin K and plasma protein-induced in vitamin K absence (PIVKA II) from birth until 40 weeks' postconceptional age in 44 premature infants. They were divided into three groups: group 1, 28 weeks' gestation or less; group 2, 29 to 32 weeks; group 3, 33 to 36 weeks.
The team notes that 1-mg intramuscular vitamin K was administered at birth, followed by 60 µg/day for infants less than 1000 g or 130 µg/day for those 1000 g or more via total parenteral nutrition. "After hyperalimentation, most received vitamin K-fortified enteral feedings with the remainder receiving unfortified breast milk."
Ten infants in each group completed the study. At 2 weeks of age, vitamin K plasma levels were highest in group 1 at 130.7 ng/mL versus 27.2 ng/mL in group 3, the researchers found. By 40 weeks' postconception, plasma levels of vitamin K were similar in all groups, ranging from 5.4 ng/mL to: 9.3 ng/mL.
"None of the postnatal plasma samples had any detectable PIVKA II," the investigators report, confirming adequate vitamin K status.
"Optimal vitamin K requirements of premature infants are undefined, but present evidence suggests that parenteral vitamin K supplementation in the first few weeks of life should be reduced," Dr. Kumar and colleagues conclude.
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