Download PDF
Thromb Haemost 1988; 60(01): 039-043
DOI: 10.1055/s-0038-1647631
Original Article
Schattauer GmbH Stuttgart

Placental Transfer of Vitamin K1 and Its Implications in Fetal Hemostasis

L Mandelbrot
1   The Centre de Diagnostic Prénatal et de Foetologie, paris, france
,
M Guillaumont
2   The Institut de Puériculture de Paris, the CERNIP Institut Pasteur, paris, france
,
M Leclercq
2   The Institut de Puériculture de Paris, the CERNIP Institut Pasteur, paris, france
,
J J Lefrère
3   The Lyon, and the Institut National de Transfusion Sanguine (Etablissement Cabanel), Paris, France
,
D Gozin
3   The Lyon, and the Institut National de Transfusion Sanguine (Etablissement Cabanel), Paris, France
,
F Daffos
1   The Centre de Diagnostic Prénatal et de Foetologie, paris, france
,
F Forestier
1   The Centre de Diagnostic Prénatal et de Foetologie, paris, france
› Author Affiliations
Further Information

Publication History

Received 27 October 1987

Accepted after revision 28 March 1988

Publication Date:
30 June 2018 (online)

  PDF Download  Permissions and Reprints

Summary

Vitamin K status was evaluated using coagulation studies and/ or vitamin IQ assays in a total of 53 normal fetuses and 47 neonates. Second trimester fetal blood samples were obtained for prenatal diagnosis under ultrasound guidance. Endogenous vitamin K1 concentrations (determined by high performance liquid chromatography) were substantially lower than maternal levels. The mean maternal-fetal gradient was 14-fold at mid trimester and 18-fold at birth. Despite low vitamin K levels, descarboxy prothrombin, detected by a staphylocoagulase assay, was elevated in only a single fetus and a single neonate.

After maternal oral supplementation with vitamin K1, cord vitamin K1 levels were boosted 30-fold at mid trimester and 60 fold at term, demonstrating placental transfer. However, these levels were substantially lower than corresponding supplemented maternal levels. Despite elevated vitamin K1 concentrations, supplemented fetuses and neonates showed no increase in total or coagulant prothrombin activity. These results suggest that the low prothrombin levels found during intrauterine life are not due to vitamin K deficiency.

Key words

Vitamin K - Placental transfer - Fetal hemostasis - Prothrombin - Descarboxy prothrombin
 

  • References

  • 1 Andrew M, Paes B, Milner R, Johnston M, Mitchell L, Tollefsen DM, Powers P. Development of the human coagulation system in the full-term infant. Blood 1987; 70: 165-172
    PubMedGoogle Scholar
  • 2 Yoshioka K, Kinoshita S, Takamiya O, Fujimura Y, Mimura Y. Abnormal antigen of factors II, VII, and IX in newborns and breastfed infants with vitamin K deficiency. Acta Haematol Jpn 1982; 45: 860-866
    PubMedGoogle Scholar
  • 3 Dam H, Tage-Hansen E, Larsen H, Plum P. The relation of vitamin K deficiency to hemorrhagic disease of the newborn. Adv Pediatr 1952; 5: 129-153
    PubMedGoogle Scholar
  • 4 Committee on Nutrition, American Academy of Pediatrics. Vitamin K compounds and the water-soluble analogues: Use in therapy and prophylaxis in pediatrics. Pediatrics 1961; 28: 501-507
    PubMedGoogle Scholar
  • 5 Vermeer C, De Boer-Van Den Berg M. Vitamin K dependent carboxylase. Haematologia 1985; 18: 71-97
    PubMedGoogle Scholar
  • 6 Suttie JW. Recent advances in hepatic Vitamin K metabolism and function. Hematology 1987; 7: 367-376
    PubMedGoogle Scholar
  • 7 Von Kries R, Gobel U, Maase B. Vitamin K deficiency in the newborn (letter). Lancet 1985; 2: 728
    PubMedGoogle Scholar
  • 8 Shapiro AD, Jacobson LJ, Armon ME, Manco-Johnson MJ, Hulac P, Lane PA, Hathaway WE. Vitamin K deficiency in the newborn infant. J Pediatr 1986; 109: 675-680
    CrossrefPubMedGoogle Scholar
  • 9 Blanchard RA, Furie BC, Barnett J. et al Vitamin K deficiency in newborns and their mothers. Thromb Haemostas 1985; 54: 226 (Abstr)
    PubMedGoogle Scholar
  • 10 Forestier F, Daffos F, Rainaut M, Solé Y, Amiral J. Vitamin K dependent proteins in fetal hemostasis at mid trimester of pregnancy. Thromb Haemostas 1985; 53: 401-403
    PubMedGoogle Scholar
  • 11 Langenberg JP, Tjaden UR. Determination of vitamin K1 in human plasma by reversed-phase high performance liquid chromatography using fluorimetric detection after post-column electrochemical reduction. J Chromatogr 1984; 305: 61-72
    CrossrefPubMedGoogle Scholar
  • 12 Shearer MJ, Crampton OF, McCarthy PT, Mattock MB. Vitamin K1 in plasma. Haemostasis 1986; 16/S5: 113 (Abstr)
    PubMedGoogle Scholar
  • 13 Pietersma-de Bruyn AL J M, Van Haard PM M. Vitamin K1 in the newborn. Clin Chim Acta 1985; 156: 299-301
    PubMedGoogle Scholar
  • 14 Sann L, Leclercq M, Troncy J, Guillaumont M, Berland M, Coeur P. Serum vitamin K1 concentration and vitamin K-dependent clotting factor activity in maternal and fetal cord blood. Am J Obstet Gynecol 1985; 153: 771-774
    CrossrefPubMedGoogle Scholar
  • 15 Daffos F, Capella-Pavlovsky M, Forestier F. Fetal blood sampling during pregnancy with a needle guided by ultrasound: A study of 606 consecutive cases. Am J Obstet Gynecol 1985; 153: 655-660
    CrossrefPubMedGoogle Scholar
  • 16 Guillaumont M, Leclercq M, Gosselet H, Makala K, Vignal B. HPLC determination of serum vitamin K1 by fluorimetric detection after post-column electrochemical reduction. J Micronutr Anal (submitted).
    PubMedGoogle Scholar
  • 17 Soulier JP, Prou-Wartelle O. Dosage de l’activité “prothrombine-coagulase”. Nouv Rev Fr Hematol 1970; 10: 41-54
    PubMedGoogle Scholar
  • 18 Soulier JP, Gozin D, Lefrère JJ. A new method to assay des-gamma carboxy prothrombin: Results obtained in 75 cases of hepatocellular carcinoma. Gastroenterology 1986; 91: 1258-1262
    CrossrefPubMedGoogle Scholar
  • 19 Guillaumont MJ, Durr FM, Combet JM, Gueho AG, Fournier BM, Sann L, Leclercq M, Frederich AH. Vitamin K1 diffusion across placenta in the rat. Dev Pharmacol Ther (in press).
    PubMedGoogle Scholar
  • 20 McCarthy P, Gau G, Shearer M. Plasma and liver levels of vitamin K in the newborn. Thromb Haemostas 1987; 58: 218 (Abstr)
    PubMedGoogle Scholar
  • 21 Hamulyak K, De Boer Van Den BergM A G, Thijssen HH W, Hemker HC, Vermeer C. The placental transport of 3(H) vitamin K1in rats. Br J Haematol 1987; 65: 335-338
    CrossrefPubMedGoogle Scholar
  • 22 Forestier F, Daffos F, Rainaut M. Absence of abnormal prothrombin-crossed Immunoelectrophoresis in fetuses during the second trimester of pregnancy. Thromb Haemostas 1985; 54: 560
    PubMedGoogle Scholar
  • 23 Malhotra OP. Effect of gamma-carboxyglutamic acids of properties of prothrombins and their fragments. In: Vitamin K Metabolism and Vitamin K Dependent Proteins. Suttie J. (ed) Univ Park Press; Baltimore: 1980: 62-65
    Google Scholar
  • 24 Bovill EG, Mann KG. Warfarin and the biochemistry of the vitamin K dependent proteins. In: New Directions in Warfarin Prophylaxis. Webster S. (ed) Plenum Press; New York (in press):
    Google Scholar
  • 25 Motohara K, Kuroki Y, Kan H, Endo F, Matsuda I. Detection of vitamin K deficiency by use of an enzyme-linked immunosorbent assay for circulating abnormal prothrombin. Pediat Res 1985; 19: 354-357
    CrossrefPubMedGoogle Scholar
  • 26 Blanchard RA, Furie BC, Jorgensen M, Kruger SF, Furie B. Acquired vitamin K-dependent carboxylation deficiency in liver disease. N Engl J Med 1981; 305: 242-248
    CrossrefPubMedGoogle Scholar
  • 27 Fournier B, Sann L, Guillaumont M, Leclercq M. Variations of phylloquinone concentrations in human milk at various stages of lactation and in cow’s milk at various seasons. Am J Clin Nutr 1987; 45: 551-558
    CrossrefPubMedGoogle Scholar
  • 28 Motohara K, Endo F, Matsuda I. Screening for late neonatal vitamin K deficiency by PIVKA in dried blood spots. Arch Dis Child 1987; 62: 370-375
    CrossrefPubMedGoogle Scholar