PEDIATRICS Vol. 81 No. 3 March 1988, pp. 423-427
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Vitamin K Effect in Low Birth Weight Infants

Takayuki Ogata MD1, Kunihiko Motohara MD1, Fumio Endo MD, PhD1, Yuichi Kondo MD1, Tetsuo Ikeda MD1, Yumiko Kudo MD1, Kaneshige Iribe MD1, and Ichiro Matsuda MD, PhD1

1 From the Department of Pediatrics, Kumamoto University Medical School, and Kumamoto Municipal Hospital, Kumamoto, Japan

Factor II coagulant antigen (FII-AG), the protein induced by vitamin K absence or antagonist II (PIVKA-II), and coagulant activity (normotest) were measured in low birth weight infants. The factor II coagulant antigen and normotest levels in one-day-old babies were lower than those of full-term infants (P < .005, P < .01, respectively). Infants whose normotest levels were less than 30% at one day (group A) received vitamin K2, and the others whose normotest levels were greater than 30% at one day (group B) were not treated. At this time, the mean factor II coagulant antigen level was significantly lower in group A than in group B (P < .05). During the first seven days of life, in 65.2% of the infants in group B the PIVKA-II level became positive, but this did not occur in any infant in group A. After vitamin K treatment, there was greater improvement in the normotest level in infants with positive PIVKA-II levels than in those with negative PIVKA-II levels. This observation indicates that the hypoprothrombinemia found in low birth weight infants at one day of age is attributable to reduced synthesis of factor II coagulant antigen in the liver at this stage, but the prophylactic administration of vitamin K seemed to be effective even in such infants, probably because of the increase in factor II coagulant antigen synthesis (P < .001) during the first seven days of life.

Key Words: vitamin K • low birth weight infant • factor II coagulant antigen • normotest • PIVKA-II

Submitted on March 2, 1987
Accepted on May 29, 1987