Clarification of etiology of neonate and infant vitamin K deficiency

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It is well known that neonatal and infantile vitamin K deficiency causes melena neonatorumand intracranial hemorrhagic disorders. These disorders occur more frequently in breast-fed babies than in bottle fed babies, but the reason is still obscure. There have been some suggestions as to how to prevent babies from having vitamin K deficiency. On the other hand, determination of endogenous concentrations of the K vitamins (phylloquinone:K1 and menaquinones:MK-4, MK-l, MK-7)in human plasma is very difficult. In this study, at first we report clear separations and determination methods of vitamins K1 and MK-4, MK-l and MK-7 in placenta with the use of thin layer chromatography, followed by high performance liquid chromatography(HPLC) and fluorometric determination after post-column chemical reduction, in maternal and umbilical cord plasma by HPLC and fluorometric determination follwed post-column electochemical reduction in maternal and umnilical cord plasma by HPLC and fluorometric determ … More ination follwed platinum reduction column. Next, we describe the availability of vitamin Ks in different tissues. Vitamins K1 and MK-4, MK-6 and MK-7 were found in placenta, and maternal plasma, much K1 and MK-48 and slightly MK-l and MK-7 were found in breast milk and amniotic membrance, and K1 and MK-4 were found in umbilical cord plasma, smniotic luid, meconium and vernix caseosa. Third, to prevent early hemorrhagic diseases of the newborn, we have administered vitamin K2 drug by i.v. or oral route to mother before delivery, and vtaimin Ks concentrations in umbilival cord plasma, maternal plasma at birth and breast milk of 5 days after delivery were found to be siginficantly high as ccompared with those of non-treated mothers group. Therefore, oral or i.v. administration of vitamin Ks drug to mother before delivery which causes early and continuos transportation of vitamin Ks from mother to neonate is safer and more preferable than intramusclar injection to neonate, whic involves a certain degree of danger. Less