Increased incidence of neonatal vitamin K deficiency resulting from maternal anticonvulsant therapy

Infants exposed to anticonvulsant drugs in the uterus appear to have an increased risk of vitamin K deficiency. Vitamin K deficiency can result in hemorrhagic disease of the newborn, which is a bleeding disorder caused by a reduction in blood coagulation factors. Detection of protein induced by vitamin K absence of factor II (PIVKA-II) is the standard test for vitamin K deficiency. Levels of vitamin K and PIVKA-II were measured in 24 pregnant women who took anticonvulsant drugs and 25 healthy pregnant women. PIVKA-II was detected in 54% of the umbilical cord blood samples from the group taking anticonvulsants compared with 20% of the samples from the other group. Vitamin K could not be detected in most of the umbilical cord samples from either group. Vitamin K levels were lower in mothers from both groups following delivery, but PIVKA-II was only detected in two of the mothers, both of whom took anticonvulsant drugs.