The influence of the diet of the newborn infant on the prothrombin index

Gellis, Sidney S.; Lyon, Robert A.

doi:10.1016/s0022-3476(41)80047-x

Cited by 19 publications

(4 citation statements)

References 4 publications

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“…The policy of early feeding of asphyxiated infants is probably responsible for maintaining the levels (Gellis and Lyon, 1941). The single low level mentioned above may well be related to the baby being small for dates rather than to birth asphyxia, as we do have evidence of low levels of vitamin K dependent factors in small-for-dates infants.…”

Section: Discussionmentioning

confidence: 73%

Coagulation Studies in Severe Birth Asphyxia

Chessells¹,

Wigglesworth²

1971

Archives of Disease in Childhood

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. Coagulation studies in severe birth asphyxia. Coagulation studies have been performed in 9 infants who were so severely asphyxiated at birth as to require assisted ventilation for at least 10 minutes. Four of the infants died, though none suffered from any bleeding tendency in life. In 2 fatal cases and 1 survivor the laboratory findings of circulating fibrin degradation products, low plasma fibrinogen, and low or rising platelet count indicated that disseminated intravascular coagulation had occurred in the first few hours of life. Fibrin thromboemboli were found in the liver and adrenals of the 2 such babies that died. One baby had a low level of vitamin K dependent factors associated with fetal growth retardation.Clinical factors common to the cases with evidence of disseminated intravascular coagulation were the need for mechanical ventilation, and the occurrence of hypothermia.Though haemostatic failure due to disseminated intravascular coagulation is likely to develop only in a small minority of birth asphyxiated infants, the possibility should be considered in any that become hypothermic within a few hours of birth.There have been a number of case reports of haemostatic failure in infants with severe birth asphyxia. Valentine (1958) and Reerink-Brongers and De Koningh (1964) reported low plasma fibrinogen levels in these infants and a similar case has been reported more recently by Skyberg and Jacobsen (1969).In theory, asphyxia could influence haemostasis in the newborn in one of two ways: either by promoting consumption of platelets and coagulation factors as a consequence of disseminated intravascular coagulation, thus resulting in a fall in platelet count, fibrinogen, factors V and VIII, and the formation of fibrin degradation products, or, by causing an exaggerated fall in the level of vitamin K dependent factors II, VII, IX, and X. A further possibility is that conditions with a high risk of birth asphyxia (e.g. fetal growth retardation) might also be associated with coagulation defects.Hathaway and Henderson (1968) investigated this problem in newborn puppies and concluded that asphyxia depressed the level of vitamin K dependent factors, but they did not measure the

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Section: Discussionmentioning

confidence: 73%

Coagulation Studies in Severe Birth Asphyxia

Chessells¹,

Wigglesworth²

1971

Archives of Disease in Childhood

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“…These findings seem to represent the typical features of classic haemorrhagic disease of the newborn and confirm the previous observations that vitamin K storage in newborn infants is inadequate to maintain their requirement after birth and that the diet is the main source of vitamin K in this period. [23][24][25][26][27] The values for protein C antigen and protein C activity in the control group were notably lower than those found in adults, as previous investigators reported. [28][29][30] Furthermore, in vitamin K deficiency, protein C activity and gammacarboxyl protein C decreased to near the values observed in patients with homozygous protein C deficiency,'2-14 while the decrease in total protein C antigen was less.…”

Section: Discussionmentioning

confidence: 83%

Relationship between vitamin K dependent coagulation factors and anticoagulants (protein C and protein S) in neonatal vitamin K deficiency.

Matsuzaka

Tanaka

Fukuda

et al. 1993

Archives of Disease in Childhood

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To determine the relationship between vitamin K dependent coagulation factors and natural anticoagulants, namely protein C and protein S, in various degrees of vitamin K deficiency, plasma values for clotting activity, protein induced by vitamin K absence (PIVKA-II), protein C antigen, gammacarboxy protein C antigen, and protein S antigen including total and free fractions and activity of protein C were measured in 66 full term and healthy breast fed neonates who did not receive vitamin K supplement at birth. The 66 neonates were divided into a control group (17 cases) and a low group (49 cases) according to their values for clotting activity-that is, 220% or <20% during the first six days of life-and vitamin K was immediately given when the neonates showed values <20%. In the low group clotting activity gammacarboxy protein C, free protein S, and protein C activity was significantly decreased to a minimum on day 2 or 3, and increased in parallel after vitamin K administration. Furthermore, they were positively correlated with one another and inversely corcorrelated with the PIVKA-II concentrations. These findings suggest that simultaneous gammacarboxylation of coagulation factors and proteins C and S acts to maintain both coagulation and anticoagulation activities in parallel at various concentrations of vitamin K. The breast milk intake in the group with low values of clotting activity was significantly lower than that in the control group during the first three days of life. Therefore, mothers should be advised to try to increase the breast milk secretion, for example, by providing frequent sucklings to infants in the first days of life. (Arch Dis Child 1993;68:297-302) Vitamin K is required for the post-translational gammacarboxylation of glutamic acid residues in the vitamin K dependent proteins,' including not only coagulation factors II, VII, IX, and X but also protein C2 and protein S,3 which are the important inhibitors of coagulation.4-7 Vitamin K deficiency results in the biosynthesis of abnormal non-gammacarboxy forms of these proteins which are functionally defective. Dysfunction of these coagulation factors and inhibitors are clinically well known and seen in such diseases as haemorrhagic disease of the newborn8-10 and thromboembolic disorders including neonatal purpura fulminans.1 1-5 As vitamin K deficiency in the early neonatal period causes haemorrhagic diseases rather than thromboembolic disorders, vitamin K deficiency has been viewed exclusively from its relevance to coagulation factors.We report our study of the changes of protein C and protein S as well as of coagulation factors from the occurrence of vitamin K deficiency to its correction with vitamin K administration. Furthermore, the relationship between the breast milk intake and vitamin K deficiency in neonates was also investigated. Subjects and methods SUBJECTSSixty six healthy, full term (range 38-41 weeks) neonates with a normal birth weight (range 2755-3970 g) aged 0 to 6 days were studied. There was no history of mater...

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“…This is probably due to the low vitamin K content of human milk (6,13). All the infants examined in this study were breast-fed.…”

Section: Discussionmentioning

confidence: 98%

“…Hemorrhagic disease in infants is strongly associated with low socioeconomic status (22) and is strikingly correlated with the practice of breast-feeding (6, 13). This is probably due to the low vitamin K content of human milk (6,13). All the infants examined in this study were breast-fed.…”

Section: Discussionmentioning

confidence: 98%

The Intestinal Microflora of Infants: Fecal Flora of Infants with Vitamin K Deficiency

Benno

Sawada²,

Mitsuoka

1985

Microbiology and Immunology

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The fecal flora of 10 infants with vitamin K deficiency (VKD) and 10 healthy infants was examined. All the infants were breast-fed. In the infants with VKD, the total counts (P< 0.01) and the numbers of bifidobacteria (P< 0.001) were lower than in the healthy infants, whereas bacteroides, veillonella and enterococci were present in greater numbers in the feces of infants with VKD. The incidence of the Bacteroides fragilis group was higher (P< 0.05) in the infants with VKD than in the healthy infants. A significant reduction (P<0.05) in Bifidobacterium breve was shown in the infants with VKD. The data emphasize the abnormal flora in infants with VKD.

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The influence of the diet of the newborn infant on the prothrombin index

Cited by 19 publications

References 4 publications

Coagulation Studies in Severe Birth Asphyxia

Coagulation Studies in Severe Birth Asphyxia

Relationship between vitamin K dependent coagulation factors and anticoagulants (protein C and protein S) in neonatal vitamin K deficiency.

The Intestinal Microflora of Infants: Fecal Flora of Infants with Vitamin K Deficiency

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