Increased incidence of neonatal vitamin K deficiency resulting from maternal anticonvulsant therapy.
OBJECTIVE
The null hypothesis of our study is that the incidence of vitamin K deficiency in mother-infant pairs exposed to anticonvulsant drugs is not higher than in controls.


METHODS
In this multicenter observational case-control study, 25 pregnant women receiving anticonvulsant therapy and 25 pregnant controls were studied for PIVKA-II (protein induced by vitamin K absence of factor II) and vitamin K1 concentrations at 32 weeks' gestation and at delivery.


RESULTS
PIVKA-II was detectable in 54% of cord samples of the anticonvulsant group and in 20% of controls (chi 2, p = 0.01). In both groups vitamin K1 cord blood levels were predominantly below the detection limit. Maternal vitamin K1 concentrations were lower in women with epilepsy than in controls (Wilcoxon's rank sum test, p < 0.05), but PIVKA-II was rarely present.


CONCLUSIONS
The incidence of vitamin K deficiency is increased in neonates exposed to anticonvulsant drugs prenatally. Their mothers, however, are rarely vitamin K deficient.
Cornelissen
M
M
Department of Pediatrics, University Hospital Nijmegen, The Netherlands.
Steegers-Theunissen
R
R
Kollée
L
L
Eskes
T
T
Vogels-Mentink
G
G
Motohara
K
K
De Abreu
R
R
Monnens
L
L
D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers; D016022:Case-Control Studies; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects; D011498:Protein Precursors / Q000378:metabolism; D011516:Prothrombin / Q000378:metabolism; D014812:Vitamin K / Q000097:blood; D014813:Vitamin K Deficiency / Q000139:chemically induced* / Q000453:epidemiology
D000927:Anticonvulsants; D015415:Biomarkers; D011498:Protein Precursors; D014812:Vitamin K; C008208:acarboxyprothrombin; D011516:Prothrombin