Article Text

Prevalence and associated risk factors for Vitamin K deficiency in mothers and their newborn babies in an East African setting
  1. S Data1,
  2. J Mwanga1,
  3. M Shearer2,3,
  4. D Harrington2,3,
  5. K Voong2,3,
  6. T Parlett2,
  7. U Wariyar1
  1. 1Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
  2. 2Haemostasis and Thrombosis, Guy's and St. Thomas's NHS Foundation Trust, London, UK
  3. 3Haemostasis and Thrombosis, Centre for Haemostasis and Thrombosis (The Haemophilia Reference Centre), London, UK


Introduction Vitamin K deficiency bleeding remains a serious but preventable problem worldwide with a high risk of mortality or permanent disability especially among exclusively breastfeeding infants. This was a cross sectional hospital based study to determine the prevalence and describe the associated risk factors for vitamin K deficiency in mothers and their newborn babies which has not been reported from Africa before.

Methods Eligible Mothers delivering from April 2010 to August 2010 between 8 am and 8 pm were consecutively enrolled in the study with ethical clearance and informed consent. Specific maternal and newborn characteristics were assessed. 2 ml of maternal venous blood and neonatal cord blood were each collected at birth, processed and serum analysed for Protein Induced by Vitamin K Absence (PIVKA II). Vitamin K deficiency was defined as a detectable PIVKA II of greater than or equal to 0.2 AU/ml. The significance of association between various maternal and newborn characteristics with vitamin K deficiency was assessed using the Chi-squared (X2) test and the strength of association determined using univariate logistic regression.

Results Forty seven (33.3%) out of the 141 mothers in the study were vitamin K deficient. Up to 65% of the babies in the study had a detectable PIVKA II with 22% having clinically significant PIVKA II levels (> 5.0 AU/ml). Eating beans or fried foods less than five times a week was associated with lower odds of vitamin K deficiency in mothers (ORs = 0.46 and 0.13 respectively). These relationships were statistically significant (p-values 0.0380 and 0.003). We found no correlation between maternal and newborn vitamin K status.

Conclusions Vitamin K deficiency is highly prevalent among newborn babies and pregnant mothers in the population studied. The lack of correlation between maternal and newborn vitamin K status leaves routine vitamin K prophylaxis to all newborn babies at birth as the effective and preventive remedy to vitamin K deficiency bleeding in infants.

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