Dynamic Monitoring And Clinical Significance Of Vitamin K Levels In Neonates With Intrahepatic Cholestasis Of Pregnant Mothers

Purpose: In this study,the correlation between maternal intrahepatic cholestasis during pregnancy and neonatal serum vitamin K levels was analyzed through dynamic monitoring of umbilical cord blood and serum vitamin K levels of neonatal healthy mothers during the same period and within 24 hours after vitamin K supplementation.To provide a theoretical basis for finding more refined vitamin K deficiency prevention programs for such neonates.Methods: Neonates(gestational age ≥34 weeks)born in Maternal and Child Health Hospital of Gansu Province from March 2021 to January 2022 were collected as subjects,including 53 neonates of mothers with intrahepatic cholestasis during pregnancy and 70 neonates of healthy mothers.General demographic and clinical data of all neonates and their mothers were collected.Umbilical cord blood was collected from all neonates after birth,and 1mg intramuscular injection of prophylactic vitamin K was given to all neonates within 6 hours.Blood samples were taken again 24 hours later to measure vitamin K levels.SPSS 25.0statistical analysis software was used for statistical analysis.Nonparametric test was used to compare the levels of serum vitamin K in the neonatal group of intrahepatic cholestasis of pregnancy(ICP group)and the control group of healthy mothers in two periods of umbilical cord blood and 24 hours after vitamin K supplementation.Multiple linear regression model was used to analyze the influencing factors of neonatal vitamin K level,and to explore the correlation between maternal cholestasis during pregnancy and neonatal vitamin K level.Results:1.The level of vitamin K in umbilical blood of neonates in ICP group was statistically different from that of healthy mothers in control group(P < 0.05),and the level of vitamin K in neonates of healthy mothers in control group was higher.However,there was no significant difference in 24-hour blood vitamin K level between ICP group and healthy mothers control group(P > 0.05).2.When gestational age ≥37 weeks or birth weight ≥2500g,the level of vitamin K in cord blood of neonates in the ICP group was statistically different from that in the non-ICP group(P < 0.05),and the level of vitamin K in cord blood of neonates in the control group of healthy mothers was higher.When gestational age < 37 weeks or birth weight < 2500 g,there was no significant difference between the two groups(P > 0.05).3.When the mothers had normal coagulation function or no other pregnancy complications,the level of vitamin K in cord blood of neonates in ICP group was statistically different from that of healthy mothers in control group(P < 0.05),and the level of vitamin K in cord blood of neonates in healthy mothers in control group was higher.There was no significant difference between the two groups when the mother had abnormal coagulation function,the mother had other pregnancy complications or the mother had normal liver function(P > 0.05).4.There was no significant difference in 24-hour blood vitamin K level between ICP group and healthy mothers control group(P > 0.05).Regardless of gestational age < 37 weeks or birth weight < 2500 g,there was no significant difference in 24-hour blood vitamin K level between the ICP group and the control group(P > 0.05).5.When the mothers had abnormal coagulation function,the 24-hour blood vitamin K level of neonates in the ICP group was significantly different from that in the non-ICP group(P <0.05).There was no significant difference in the 24-hour blood vitamin K level between the ICP group and the control group(P > 0.05),regardless of whether the mother had other pregnancy complications or the maternal blood loss during childbirth.When the mothers had normal coagulation function or liver function,there was no significant difference in the24-hour blood vitamin K level between the ICP group and the healthy mothers control group(P > 0.05).6.Multiple linear regression analysis of factors affecting neonatal blood vitamin K level showed that maternal serum total bile acid value ≥40μmol/L was a risk factor for neonatal cord blood vitamin K level(P < 0.05).Neonatal birth weight ≥2500g was a protective factor for 24-hour blood vitamin K levels(P < 0.05).Conclusion:1.The level of vitamin K in cord blood of neonates with intrahepatic cholestasis of pregnancy(gestational age ≥ 34 weeks,birth weight ≥ 1500g)is significantly lower than that of neonates with healthy mothers,so the incidence of premature onset of vitamin K deficiency hemorrhagic disease may be higher than that of normal neonates.A normal dose of vitamin K supplementation(1mg intramuscular injection of vitamin K)for newborns with intrahepatic cholestasis of pregnancy can prevent the occurrence of early onset of vitamin K deficiency hemorrhamia.2.Maternal serum total bile acid value ≥40μmol/L is a risk factor for neonatal vitamin K level.