title: PIVKA-II plasma levels as markers of subclinical vitamin K deficiency in term infants.
abstract: BACKGROUND
  As the vitamin K content of human milk is low and the newborn infant's stores of vitamin K are small, vitamin K deficiency with hemorrhage in the newborn is a worldwide problem. Proteins Induced by Vitamin K Absence (PIVKA-II) are the inactive under-γ-carboxylated forms of vitamin K-dependent clotting factors and they could be useful in predicting subclinical vitamin K deficiency (VKD).
  
  
  OBJECTIVE
  To demonstrate that PIVKA-II are earlier markers of subclinical VKD than Prothrombin time (PT) in exclusively breast-fed newborns.
  
  
  METHODS
  A prospective, controlled, randomized study, including 53 term newborns receiving vitamin K prophylaxis (0.5 mg i.m.) at birth, was performed. At 30 days newborns were divided into three groups (G) receiving respectively: 25 μg/die of vitamin K (G I), 12 μg/die (G II) or placebo (G III). PIVKA-II and PT were measured on 30th and 90th days of life.
  
  
  RESULTS
  G III and GII showed a significant increase in PIVKA-II from 30 to 90 days of life respectively from 2.6 to 4.7 (p = 0.001) and from 2.3 to 3.5 (p < 0.001). No significant changes were found in GI. PT showed no significant changes among groups.
  
  
  CONCLUSIONS
  PT is a less sensitive marker than PIVKA II. Oral supplementation with 25 μg/die avoids an increase of PIVKA-II. Despite increased PIVKA-II do not mean an impending occurrence of bleeding, they highlight a subclinical VKD and its relative risk.
authors.affiliation: Department of Maternal and Child Health, S. Giovanni Calibita Hospital, Fatebenefratelli, Rome.
authors.forename: F
authors.initials: F
authors.lastname: Dituri
authors.forename: G
authors.initials: G
authors.lastname: Buonocore
authors.forename: A
authors.initials: A
authors.lastname: Pietravalle
authors.forename: F
authors.initials: F
authors.lastname: Naddeo
authors.forename: M
authors.initials: M
authors.lastname: Cortesi
authors.forename: P
authors.initials: P
authors.lastname: Pasqualetti
authors.forename: M L
authors.initials: ML
authors.lastname: Tataranno
authors.forename: R
authors.initials: R
authors.lastname: Agostino
mesh_terms: D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000032:analysis / Q000097:blood*; D019587:Dietary Supplements; D042241:Early Diagnosis; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011498:Protein Precursors / Q000032:analysis / Q000097:blood* / Q000502:physiology; D011516:Prothrombin / Q000032:analysis / Q000502:physiology; D011517:Prothrombin Time; D047929:Term Birth / Q000097:blood*; D013997:Time Factors; D014812:Vitamin K / Q000008:administration & dosage; D014813:Vitamin K Deficiency / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; D014812:Vitamin K; C008208:acarboxyprothrombin; D011516:Prothrombin