Effect of maternal anticonvulsant treatment on neonatal blood coagulation. Issue 3 (1st November 1999)

• Record Type: Journal Article
• Authors: Hey, Edmund
• Is Part Of: Archives of disease in childhood. Volume 81:Issue 3(1999)
• Page Start: F208
• Page End: F210
• Publication Date: 1999-11-01
• Subjects: anticonvulsant medication in pregnancy -- early vitamin K deficiency bleeding -- prothrombin deficiency; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/fn.81.3.F208
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : AIMS: To investigate the impact of maternal anticonvulsant use on the ability of cord blood to coagulate. METHODS: Cord blood prothrombin times were measured, over 15 years in a consecutive series of 137 term babies born to women taking phenobarbitone, phenytoin, and/or carbamazepine while pregnant. The response to parenteral vitamin K was measured in 83 neonates. RESULTS: Only 14 of the 105 babies born to the mothers who had therapeutic anticonvulsant blood concentrations at birth had a prolonged prothrombin time (outside the 95% reference range). None had an overt bleeding tendency. The abnormality was corrected within 2 hours by 1 mg of parenteral vitamin K, but rapid intravenous prophylaxis produced complications in three infants. CONCLUSIONS: A policy of giving vitamin K throughout the last third of pregnancy to all women being treated with anticonvulsants, as recently recommended, is not justified by the available evidence. The belief that there is a distinct, early form of neonatal vitamin K deficiency that is different from, and more dangerous than, the classic form of the disease, is not supported by a review of the published evidence.