Gulsedef Arslan, Luis Gutierrez, Matthew Mozzo, Vaishali Jadhav and Aliu Sanni
Philadelphia College of Osteopathic Medicine, Georgia
Eastside Bariatric and General Surgery LLC, Georgia
Posters & Accepted Abstracts: J Vaccines Vaccin
Introduction: Periventricular-Intraventricular Hemorrhage (PIVH) is a severe condition in preterm births that can lead to longterm morbidity and eventually mortality. The pathophysiology of PIVH is unknown and thought to have a multifactorial etiology. Vitamin K dependent coagulation factors in preterm neonates are not clinically adequate and may contribute to the increased risk for PIVH. The aim of this study was to determine if antenatal administration of vitamin K has a protective role against PIVH in preterm neonates. Methods: A systemic review was conducted using PubMed to identify relevant studies from January 1988 through January 2014. The review focused on comparative data on maternal antenatal vitamin K administration versus no antenatal vitamin K administration in preterm neonates. The primary outcome analyzed was the incidence of PIVH in preterm babies who received maternal vitamin K (treatment group) prior to birth versus no vitamin K (control group) administration. The other outcomes analyzed were prothrombin time (PT), activated partial thromboplastin time (PTT), and vitamin K-dependent clotting factor, factor II (prothrombin). The results are expressed as a standard difference in means with standard deviation. Statistical analysis was done using fixed-effects meta-analysis to compare the mean value of the separate groups. (Comprehensive Meta-Analysis Version 3.3.070 software; Biostat Inc., Englewood NJ.) Results: Four out of 29 studies were included in this meta-analysis. Among the four studies, 137 patients received treatment whereas 146 patients received no treatment. The incidence of PIVH (-0.411±0.128, p=0.001), a PT time (-0.637±0.50, p=0.00), and a PTT time (-0.831±0.164, p=0.000) were lower in the treatment group. The activity of factor II (0.678±0.168, p=0.000) was higher in the treatment group when compared to the control group. Conclusion: Antenatal administration of vitamin K has a protective role against PIVH in preterm neonates.
E-mail: gulsedefar@pcom.edu