PIVKA-II plasma levels as markers of subclinical vitamin K deficiency in term infants

F. Dituri, G. Buonocore, A. Pietravalle, F. Naddeo, M. Cortesi, P. Pasqualetti, M. L. Tataranno, R. Agostino

Research output: Contribution to journalArticlepeer-review


Background: As the vitamin K content of human milk is low and the newborn infant's stores of vitamin K are small, vitamin K deficiency with hemorrhage in the newborn is a worldwide problem. Proteins Induced by Vitamin K Absence (PIVKA-II) are the inactive under-γ-carboxylated forms of vitamin K-dependent clotting factors and they could be useful in predicting subclinical vitamin K deficiency (VKD). Objectives: To demonstrate that PIVKA-II are earlier markers of subclinical VKD than Prothrombin time (PT) in exclusively breast-fed newborns. Methods: A prospective, controlled, randomized study, including 53 term newborns receiving vitamin K prophylaxis (0.5 mg i.m.) at birth, was performed. At 30 days newborns were divided into three groups (G) receiving respectively: 25 μg/die of vitamin K (G I), 12 μg/die (G II) or placebo (G III). PIVKA-II and PT were measured on 30th and 90th days of life. Results: G III and GII showed a significant increase in PIVKA-II from 30 to 90 days of life respectively from 2.6 to 4.7 (p = 0.001) and from 2.3 to 3.5 (p <0.001). No significant changes were found in GI. PT showed no significant changes among groups. Conclusions: PT is a less sensitive marker than PIVKA II. Oral supplementation with 25 μg/die avoids an increase of PIVKA-II. Despite increased PIVKA-II do not mean an impending occurrence of bleeding, they highlight a subclinical VKD and its relative risk.

Original languageEnglish
Pages (from-to)1660-1663
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number9
Publication statusPublished - Sep 2012


  • Prophylaxis
  • Vitamin K deficiency

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology


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