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Vitamin K1 monitoring in pregnancies after bariatric surgery: a prospective cohort study.
Surg Obes Relat Dis 2014 Sep-Oct; 10(5):885-90SO

Abstract

BACKGROUND

Neonatal intracranial bleedings and birth defects have been reported, possibly related to maternal vitamin K1 deficiency during pregnancy after bariatric surgery. The objective of this study was to investigate the effects of screening and supplementation on K1 serum levels in pregnant women with bariatric surgery, and to compare K1 levels and prothrombin time (PT %) in the first trimester with pregnant women without bariatric surgery.

METHODS

A prospective cohort study including 49 pregnant women with bariatric surgery. Nutritional deficiencies were prospectively screened. In case of observed low K1 serum levels, supplementation was provided. K1 serum levels and PT (%) during the first trimester were compared with a nonsurgical control group of 27 women.

RESULTS

During the first trimester, most women had low K1 serum levels (<0.8 nmol/l). Mean vitamin K1 levels were significantly lower in the surgical group compared to the nonsurgical control group (.44 versus .64 nmol/l; P = .016). PT (%) remained in the normal range, The surgery group showed a higher mean PT compared to the controls (111.3 versus 98.9%; P<.001) Mean K1 serum levels in the study group were higher during the third than during the first trimester (P = .014). PT (%) was significantly higher during the second and third than during the first trimester (P = .004). Most of the coagulation factors, including II, V, VII, IX, and X, remained within normal ranges.

CONCLUSION

Low circulating K1 appears to be common in pregnant women with and without bariatric surgery. Supplementation during pregnancy can restore vitamin K1 in women with bariatric surgery, potentially protecting the fetus and newborn against intracranial hemorrhage.

Authors+Show Affiliations

Department of Development and Regeneration, Unit Pregnancy, Fetus and Newborn, KU Leuven, Belgium.Department of Public Health and Primary Care; Environment and Health, section nutrition, KU Leuven, Belgium.Jessa Hospital Hasselt, Belgium.Department of Development and Regeneration, Unit Pregnancy, Fetus and Newborn, KU Leuven, Belgium; Department of Gynecology and Obstetrics, University Hospitals Leuven, Belgium.Department of Medical Laboratories/Diagnostic Centre SSDZ, Reinier de Graaf Group of Hospitals, Association of Clinical Chemistry, Delft, the Netherlands.Department of Public Health and Primary Care; Environment and Health, section nutrition, KU Leuven, Belgium.Department of Development and Regeneration, Unit Pregnancy, Fetus and Newborn, KU Leuven, Belgium; Department of Gynecology and Obstetrics, University Hospitals Leuven, Belgium. Electronic address: roland.devlieger@uzleuven.be.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25264330

Citation

Jans, Goele, et al. "Vitamin K1 Monitoring in Pregnancies After Bariatric Surgery: a Prospective Cohort Study." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 10, no. 5, 2014, pp. 885-90.
Jans G, Guelinckx I, Voets W, et al. Vitamin K1 monitoring in pregnancies after bariatric surgery: a prospective cohort study. Surg Obes Relat Dis. 2014;10(5):885-90.
Jans, G., Guelinckx, I., Voets, W., Galjaard, S., Van Haard, P. M., Vansant, G. M., & Devlieger, R. (2014). Vitamin K1 monitoring in pregnancies after bariatric surgery: a prospective cohort study. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 10(5), pp. 885-90. doi:10.1016/j.soard.2014.04.032.
Jans G, et al. Vitamin K1 Monitoring in Pregnancies After Bariatric Surgery: a Prospective Cohort Study. Surg Obes Relat Dis. 2014;10(5):885-90. PubMed PMID: 25264330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin K1 monitoring in pregnancies after bariatric surgery: a prospective cohort study. AU - Jans,Goele, AU - Guelinckx,Isabelle, AU - Voets,Willy, AU - Galjaard,Sander, AU - Van Haard,Paul M M, AU - Vansant,Greet M, AU - Devlieger,Roland, Y1 - 2014/05/20/ PY - 2013/10/28/received PY - 2014/04/22/revised PY - 2014/04/24/accepted PY - 2014/9/30/entrez PY - 2014/9/30/pubmed PY - 2015/8/4/medline KW - Bariatric surgery KW - Obesity surgery KW - Pregnancy KW - Vitamin K1 SP - 885 EP - 90 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 10 IS - 5 N2 - BACKGROUND: Neonatal intracranial bleedings and birth defects have been reported, possibly related to maternal vitamin K1 deficiency during pregnancy after bariatric surgery. The objective of this study was to investigate the effects of screening and supplementation on K1 serum levels in pregnant women with bariatric surgery, and to compare K1 levels and prothrombin time (PT %) in the first trimester with pregnant women without bariatric surgery. METHODS: A prospective cohort study including 49 pregnant women with bariatric surgery. Nutritional deficiencies were prospectively screened. In case of observed low K1 serum levels, supplementation was provided. K1 serum levels and PT (%) during the first trimester were compared with a nonsurgical control group of 27 women. RESULTS: During the first trimester, most women had low K1 serum levels (<0.8 nmol/l). Mean vitamin K1 levels were significantly lower in the surgical group compared to the nonsurgical control group (.44 versus .64 nmol/l; P = .016). PT (%) remained in the normal range, The surgery group showed a higher mean PT compared to the controls (111.3 versus 98.9%; P<.001) Mean K1 serum levels in the study group were higher during the third than during the first trimester (P = .014). PT (%) was significantly higher during the second and third than during the first trimester (P = .004). Most of the coagulation factors, including II, V, VII, IX, and X, remained within normal ranges. CONCLUSION: Low circulating K1 appears to be common in pregnant women with and without bariatric surgery. Supplementation during pregnancy can restore vitamin K1 in women with bariatric surgery, potentially protecting the fetus and newborn against intracranial hemorrhage. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/25264330/Vitamin_K1_monitoring_in_pregnancies_after_bariatric_surgery:_a_prospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(14)00214-7 DB - PRIME DP - Unbound Medicine ER -