Dynamic Changes And Influencing Factors Of Vitamin K Level In Neonates

Objective:To investigate the deficiency rates of vitamin K1 and K2 in umbilical cord blood of neonates,and to explore the dynamic changes and influencing factors of serum vitamin K1 level after preventive vitamin K1 supplementation in neonates.Methods:A retrospective study was conducted on neonates born in the Department of Obstetrics of Shanxi Children’s Hospital from January 2021 to January 2022.Cord blood vitamin K1,vitamin K2,serum vitamin K1 levels 14 days and 28 days after vitamin K1supplementation and clinical data were collected.According to whether they were hospitalized or not,the neonates were divided into hospitalized neonates and healthy neonates.According to gestational age（GA）,the neonates were divided into early and moderate preterm infants,late preterm infants,and full-term infants.SPSS 25.0 statistical software was used to compare the dynamic changes of vitamin K1 levels between hospitalized preterm infants and hospitalized full-term infants,healthy full-term infants and hospitalized full-term infants.Multiple linear regression was used to analyze the influencing factors of vitamin K1 in hospitalized neonates at 28 days.Results:A total of 190 neonates were finally included.1.There was no significant difference in the deficiency rate of vitamin K1 and K2 in umbilical cord blood of neonates with different gestational ages（P>0.05）,but the overall deficiency rate was high,which both were 85.0%.2.The levels of vitamin K1 in hospitalized full-term infants on day 14 and day 28were higher than those in hospitalized preterm infants[（13.21±2.48）ng/m L vs.（8.48±1.41）ng/m L,（4.31±0.78）ng/m L vs.（2.81±0.66）ng/m L].The difference between the two groups was statistically significant（P<0.05）.The level of vitamin K1 in the healthy full-term group was higher than that in the hospitalized full-term group[（4.76±0.84）ng/m L vs.（4.31±0.78）ng/m L,P<0.05].3.Multivariate Logistic regression analysis showed that maternal complications during pregnancy（OR=5.889,95%CI=1.621～21.399,P=0.007）and neonatal antibiotic use（OR=5.615,95%CI=1.833～17.221,P=0.003）was a risk factor for neonatal vitamin K₁ deficiency,and feeding pattern（OR=0.389,95%CI=0.193～0.786,P=0.008）was a protective factor for neonatal vitamin K₁deficiency.Conclusions:1.Vitamin K deficiency is common in neonates.2.After prophylactic vitamin K1 supplementation,the serum vitamin K1 level of neonates increased significantly,and showed a downward trend with the increase of day age.The level of vitamin K1 in hospitalized full-term infants was higher than that in hospitalized preterm infants on day 14 and 28.The level of vitamin K1 in healthy full-term infants was higher than that in hospitalized full-term infants on day 28.3.Many factors affect the vitamin K1 level of hospitalized neonates,so it is necessary to develop an individualized supplementation plan.