Article Prevalence and Predictors of Functional Vitamin K Insufficiency in Mothers and Newborns in Uganda

Abstract: Vitamin K deficiency bleeding (VKDB) in infancy is a serious but preventable cause of mortality or permanent disability. Lack of epidemiologic data for VKDB in sub-Saharan Africa hinders development and implementation of effective prevention strategies. We used convenience sampling to consecutively enroll mothers delivering in a southwestern Uganda Hospital. We collected socio-demographic and dietary information, and paired samples of maternal venous and neonatal cord blood for the immunoassay of undercarboxylated prothrombin (PIVKA-II), a sensitive marker of functional vitamin K (VK) insufficiency. We used univariable and multivariable logistic regression models to identify predictors of VK insufficiency. We detected PIVKA-II of ě0.2 AU (Arbitrary Units per mL)/mL (indicative of VK insufficiency) in 33.3 % (47/141) of mothers and 66 % (93/141) of newborns. Importantly, 22 % of babies had PIVKA-II concentrations ě5.0 AU/mL, likely to be associated with abnormal coagulation indices. We found no significant predictors of newborn VK insufficiency, including infant weight (AOR (adjusted odds ratio) 1.85, 95 % CI (confidence interval) 0.15–22.49), gender (AOR 0.54, 95 % CI 0.26–1.11), term birth (AOR 0.72, 95 % CI 0.20–2.62), maternal VK-rich diet (AOR 1.13, 95 % CI 0.55–2.35) or maternal VK insufficiency (AOR 0.99, 95 % CI 0.47–2.10). VK insufficiency is common among mothers an