Hyperemesis gravidarum and vitamin K deficiency: a systematic review
What this study found
Vitamin K deficiency and related complications were reported in hyperemesis gravidarum, and supplementation was associated with normalization of prothrombin time in the reported cases. Among 21 women in the case reports, 8/21 (38.1%) had prolonged prothrombin time; in the cohort study, 10/39 (25.6%) had prolonged prothrombin time, and 2/10 had levels below 50%. Vitamin K was administered to 10/21 women and 1 neonate, with most maternal cases receiving intravenous vitamin K. Reported complications included maternal coagulopathy-related hemorrhage and neonatal intracranial haemorrhage or…
- Study & population
- Systematic review of case reports and one retrospective cohort study in pregnant women with hyperemesis gravidarum and vitamin K-related coagulopathy or deficiency, with some neonatal outcomes also described.
- Intervention
- Vitamin K supplementation was used to treat or prevent vitamin K deficiency in pregnancies complicated by hyperemesis gravidarum.
- Key limitation
- The evidence is limited to case reports plus one retrospective cohort, so incidence and causality cannot be established.
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Open PDFOriginal abstract
Abstract Hyperemesis gravidarum (HG), severe nausea and vomiting in pregnancy, can lead to vitamin deficiencies. Little is known about HG-related vitamin K deficiency. We aimed to summarise available evidence on the occurrence of HG-related vitamin K deficiency and corresponding maternal and neonatal complications. A systematic review was conducted, searching Medline and EMBASE from inception to 12 November 2020. We identified 1564 articles, of which we included fifteen in this study: fourteen case reports (n 21 women) and one retrospective cohort study (n 109 women). Nine out of twenty-one women reported in case reports had a prolonged prothrombin time (PT). The cohort study measured PT in 39/109 women with HG, of whom 10/39 women (26 %) had prolonged PT. In total, 30–50 % women received vitamin K supplementation after vitamin K deficiency had been diagnosed. Four case reports (n 4 women) reported corresponding maternal complications, all consisting of coagulopathy-related haemorrhage. Nine case reports (n 16 neonates) reported corresponding neonatal complications including intracranial haemorrhage (n 2 neonates) and embryopathy (n 14 neonates), which consisted of Binder phenotype (n 14 neonates), chondrodysplasia punctata (n 9 neonates) and grey matter heterotopia (n 3 neonates). In conclusion, vitamin K deficiency and related complications occur among women with HG. In our systematic review, we were unable to assess the incidence rate.