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Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda

Vitamin K deficiency bleeding (VKDB) in infancy is a serious but preventable cause of mortality or permanent disability. Lack of epidemiologic data for VKDB in sub-Saharan Africa hinders development and implementation of effective prevention strategies. We used convenience sampling to consecutively...

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Autores principales: Santorino, Data, Siedner, Mark J., Mwanga-Amumpaire, Juliet, Shearer, Martin J., Harrington, Dominic J., Wariyar, Unni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632428/
https://www.ncbi.nlm.nih.gov/pubmed/26501317
http://dx.doi.org/10.3390/nu7105408
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author Santorino, Data
Siedner, Mark J.
Mwanga-Amumpaire, Juliet
Shearer, Martin J.
Harrington, Dominic J.
Wariyar, Unni
author_facet Santorino, Data
Siedner, Mark J.
Mwanga-Amumpaire, Juliet
Shearer, Martin J.
Harrington, Dominic J.
Wariyar, Unni
author_sort Santorino, Data
collection PubMed
description Vitamin K deficiency bleeding (VKDB) in infancy is a serious but preventable cause of mortality or permanent disability. Lack of epidemiologic data for VKDB in sub-Saharan Africa hinders development and implementation of effective prevention strategies. We used convenience sampling to consecutively enroll mothers delivering in a southwestern Uganda Hospital. We collected socio-demographic and dietary information, and paired samples of maternal venous and neonatal cord blood for the immunoassay of undercarboxylated prothrombin (PIVKA-II), a sensitive marker of functional vitamin K (VK) insufficiency. We used univariable and multivariable logistic regression models to identify predictors of VK insufficiency. We detected PIVKA-II of ≥0.2 AU (Arbitrary Units per mL)/mL (indicative of VK insufficiency) in 33.3% (47/141) of mothers and 66% (93/141) of newborns. Importantly, 22% of babies had PIVKA-II concentrations ≥5.0 AU/mL, likely to be associated with abnormal coagulation indices. We found no significant predictors of newborn VK insufficiency, including infant weight (AOR (adjusted odds ratio) 1.85, 95% CI (confidence interval) 0.15–22.49), gender (AOR 0.54, 95% CI 0.26–1.11), term birth (AOR 0.72, 95% CI 0.20–2.62), maternal VK-rich diet (AOR 1.13, 95% CI 0.55–2.35) or maternal VK insufficiency (AOR 0.99, 95% CI 0.47–2.10). VK insufficiency is common among mothers and newborn babies in southwestern Uganda, which in one fifth of babies nears overt deficiency. Lack of identifiable predictors of newborn VK insufficiency support strategies for universal VK prophylaxis to newborns to prevent VKDB.
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spelling pubmed-46324282015-11-30 Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda Santorino, Data Siedner, Mark J. Mwanga-Amumpaire, Juliet Shearer, Martin J. Harrington, Dominic J. Wariyar, Unni Nutrients Article Vitamin K deficiency bleeding (VKDB) in infancy is a serious but preventable cause of mortality or permanent disability. Lack of epidemiologic data for VKDB in sub-Saharan Africa hinders development and implementation of effective prevention strategies. We used convenience sampling to consecutively enroll mothers delivering in a southwestern Uganda Hospital. We collected socio-demographic and dietary information, and paired samples of maternal venous and neonatal cord blood for the immunoassay of undercarboxylated prothrombin (PIVKA-II), a sensitive marker of functional vitamin K (VK) insufficiency. We used univariable and multivariable logistic regression models to identify predictors of VK insufficiency. We detected PIVKA-II of ≥0.2 AU (Arbitrary Units per mL)/mL (indicative of VK insufficiency) in 33.3% (47/141) of mothers and 66% (93/141) of newborns. Importantly, 22% of babies had PIVKA-II concentrations ≥5.0 AU/mL, likely to be associated with abnormal coagulation indices. We found no significant predictors of newborn VK insufficiency, including infant weight (AOR (adjusted odds ratio) 1.85, 95% CI (confidence interval) 0.15–22.49), gender (AOR 0.54, 95% CI 0.26–1.11), term birth (AOR 0.72, 95% CI 0.20–2.62), maternal VK-rich diet (AOR 1.13, 95% CI 0.55–2.35) or maternal VK insufficiency (AOR 0.99, 95% CI 0.47–2.10). VK insufficiency is common among mothers and newborn babies in southwestern Uganda, which in one fifth of babies nears overt deficiency. Lack of identifiable predictors of newborn VK insufficiency support strategies for universal VK prophylaxis to newborns to prevent VKDB. MDPI 2015-10-16 /pmc/articles/PMC4632428/ /pubmed/26501317 http://dx.doi.org/10.3390/nu7105408 Text en © 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons by Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Santorino, Data
Siedner, Mark J.
Mwanga-Amumpaire, Juliet
Shearer, Martin J.
Harrington, Dominic J.
Wariyar, Unni
Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda
title Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda
title_full Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda
title_fullStr Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda
title_full_unstemmed Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda
title_short Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda
title_sort prevalence and predictors of functional vitamin k insufficiency in mothers and newborns in uganda
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4632428/
https://www.ncbi.nlm.nih.gov/pubmed/26501317
http://dx.doi.org/10.3390/nu7105408
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