Matsuoka Ryo, Nonaka Emi, Fujita Satoshi, Akiyama Naoe
Department of Pediatrics, Fuji City General Hospital, Fuji, JPN.
Department of Pediatrics, Jikei University School of Medicine, Tokyo, JPN.
Cureus. 2024 Nov 25;16(11):e74436. doi: 10.7759/cureus.74436. eCollection 2024 Nov.
In Japan, three doses of vitamin K are administered to neonates as prophylactic regimens against vitamin K deficiency bleeding (VKDB). In this study, we aimed to evaluate the efficacy of this prophylactic vitamin K regimen using the hepaplastin test (HPT) performed one, two weeks, and one month after birth. The secondary aim of this study was to evaluate the utility of HPT screening in healthy neonates.
This study included a retrospective analysis of HPT values in neonates born between June 2009 and February 2018 using the prophylactic regimen implemented in 2011.
The study group included 6075 neonates, of whom 274 (4.5%) had a low HPT value (<40%) at the time of discharge (approximately one week after birth). Follow-up HPT was performed in 118 neonates at two weeks, with a low HPT value persisting in 11 neonates (9%). There was no effect of breast or formula milk on HPT values, and all neonates achieved an HPT value >40% at one month, regardless of whether vitamin K supplementation was provided at two weeks. None of the infants had underlying diseases that led to secondary VKDB.
Healthy newborns maintained adequate HPT values with the triple-dose vitamin K administration, regardless of the feeding method. Therefore, HPT screening might not be essential for healthy neonates.
在日本,给新生儿接种三剂维生素K作为预防维生素K缺乏性出血(VKDB)的方案。在本研究中,我们旨在通过在出生后1周、2周和1个月进行的肝促凝血酶原激酶试验(HPT)来评估这种预防性维生素K方案的疗效。本研究的次要目的是评估HPT筛查在健康新生儿中的实用性。
本研究对2009年6月至2018年2月期间出生的新生儿的HPT值进行回顾性分析,采用2011年实施的预防方案。
研究组包括6075名新生儿,其中274名(4.5%)在出院时(出生后约1周)HPT值较低(<40%)。118名新生儿在2周时进行了随访HPT,11名新生儿(9%)的HPT值持续较低。母乳或配方奶对HPT值没有影响,所有新生儿在1个月时HPT值均>40%,无论在2周时是否补充维生素K。没有婴儿患有导致继发性VKDB的基础疾病。
无论喂养方式如何,健康新生儿通过三剂维生素K给药维持了足够的HPT值。因此,HPT筛查对健康新生儿可能不是必需的。