{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:17:12Z","timestamp":1761488232709,"version":"3.44.0"},"reference-count":28,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[1999,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>AIMS<\/jats:title>\n                  <jats:p>To investigate the impact of maternal anticonvulsant use on the ability of cord blood to coagulate.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Cord blood prothrombin times were measured, over 15 years in a consecutive series of 137 term babies born to women taking phenobarbitone, phenytoin, and\/or carbamazepine while pregnant. The response to parenteral vitamin K was measured in 83 neonates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Only 14 of the 105 babies born to the mothers who had therapeutic anticonvulsant blood concentrations at birth had a prolonged prothrombin time (outside the 95% reference range). None had an overt bleeding tendency. The abnormality was corrected within 2 hours by 1 mg of parenteral vitamin K, but rapid intravenous prophylaxis produced complications in three infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>A policy of giving vitamin K throughout the last third of pregnancy to all women being treated with anticonvulsants, as recently recommended, is not justified by the available evidence. The belief that there is a distinct, early form of neonatal vitamin K deficiency that is different from, and more dangerous than, the classic form of the disease, is not supported by a review of the published evidence.<\/jats:p>\n                  <jats:p>\n                     <jats:boxed-text position=\"float\">\n                        <jats:sec>\n                           <jats:title>Key messages<\/jats:title>\n                           <jats:list list-type=\"simple\">\n                              <jats:list-item>\n                                 <jats:p>Few babies born to women taking phenobarbitone, phenytoin and\/or carbamazepine have an overt bleeding tendency at birth, although 13% have a prothrombin time that is longer than normal (above the 95% reference range)<\/jats:p>\n                              <\/jats:list-item>\n                              <jats:list-item>\n                                 <jats:p>A significant number of women seem to be taking subtherapeutic doses of these potentially teratogenic anticonvulsants in an unsupervised (and probably unnecessary) way<\/jats:p>\n                              <\/jats:list-item>\n                              <jats:list-item>\n                                 <jats:p>Parenteral treatment at delivery suffices to correct the coagulation abnormality within 2 hours (the adequacy of oral treatment remains undetermined)<\/jats:p>\n                              <\/jats:list-item>\n                           <\/jats:list>\n                        <\/jats:sec>\n                     <\/jats:boxed-text>\n                  <\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fn.81.3.f208","type":"journal-article","created":{"date-parts":[[2009,4,8]],"date-time":"2009-04-08T11:39:47Z","timestamp":1239190787000},"page":"F208-F210","source":"Crossref","is-referenced-by-count":31,"title":["Effect of maternal anticonvulsant treatment on neonatal blood coagulation: Figure 1"],"prefix":"10.1136","volume":"81","author":[{"given":"Edmund","family":"Hey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1999,11,1]]},"reference":[{"key":"2025090510103418000_81.3.F208.1","first-page":"721","article-title":"Nouveaux aspects de la maladie h\u00e9morragique du nouveau-n\u00e9.","volume":"15","author":"van Creveld","year":"1958","journal-title":"Arch Fr Pediatr"},{"key":"2025090510103418000_81.3.F208.2","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/S0140-6736(70)90636-7","article-title":"Neonatal coagulation defect due to anticonvulsant drug treatment in pregnancy.","volume":"i","author":"Mountain","year":"1970","journal-title":"Lancet"},{"key":"2025090510103418000_81.3.F208.3","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/S0002-9378(12)90846-7","article-title":"Increased incidence of neonatal vitamin K deficiency resulting from maternal anticonvulsant exposure.","volume":"168","author":"Cornelissen","year":"1993","journal-title":"Am J Obstet Gynecol"},{"doi-asserted-by":"crossref","unstructured":"\u00c5stedt B (1995) Antenatal drugs affecting the vitamin K status of the fetus and the newborn. Sutor AH, Hathaway WE, eds. Vitamin K in Infancy. (Schattauer, Stuttgart), pp 85\u201391.","key":"2025090510103418000_81.3.F208.4","DOI":"10.1055\/s-2007-1000657"},{"key":"2025090510103418000_81.3.F208.5","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/S0140-6736(66)91894-0","article-title":"Haemorrhage in the newborn.","volume":"i","author":"Douglas","year":"1966","journal-title":"Lancet"},{"key":"2025090510103418000_81.3.F208.6","first-page":"31","article-title":"Avitaminose K neonatale sev\u00e8re chez 2 enfants n\u00e9s de m\u00e8re trait\u00e9e par des anticomitiaux.","volume":"25","author":"Alagille","year":"1968","journal-title":"Arch Fr Pediatr"},{"key":"2025090510103418000_81.3.F208.7","first-page":"695","article-title":"Th\u00e9rapeutique anticomitiale administr\u00e9e pendant la grossese et maladie h\u00e9morragique du nouveau-n\u00e9. Remarques critiques \u00e0 propos de trois observations personnelles.","volume":"63","author":"Monnet","year":"1968","journal-title":"Rev Fr Gynecol Obstet"},{"key":"2025090510103418000_81.3.F208.8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/000992287201100117","article-title":"Hemorrhagic disease of the newborn. An unusual case related to maternal ingestion of an anti-epileptic drug.","volume":"11","author":"Margolin","year":"1972","journal-title":"Clin Ped"},{"key":"2025090510103418000_81.3.F208.9","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1055\/s-0028-1107939","article-title":"H\u00e4morrhagische diasthese bei einen neugeborenen einer mutter mit antiepilischer therapie.","volume":"99","author":"Waltl","year":"1974","journal-title":"Dtsch Med Wochenschr"},{"doi-asserted-by":"publisher","key":"2025090510103418000_81.3.F208.10","DOI":"10.1001\/jama.1976.03260320034020"},{"key":"2025090510103418000_81.3.F208.11","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1016\/S0140-6736(81)91542-7","article-title":"Neonatal haemorrhage associated with maternal anticonvulsant therapy.","volume":"ii","author":"Griffiths","year":"1981","journal-title":"Lancet"},{"key":"2025090510103418000_81.3.F208.12","first-page":"250","article-title":"Maternal anticonvulsant therapy and hemorrhagic disease of the newborn.","volume":"59","author":"Srinivasan","year":"1982","journal-title":"Obstet Gynecol"},{"key":"2025090510103418000_81.3.F208.13","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/S0140-6736(83)91921-9","article-title":"Haemorrhagic disease of the newborn returns.","volume":"i","author":"McNinch","year":"1983","journal-title":"Lancet"},{"unstructured":"Tripp J Cornelissen M Loughnan P McNinch A Schubiger G von Kries R (1995) Suggested protocol for the reporting of prospective studies of vitamin K deficiency bleeding (previously called hemorrhagic disease of the newborn). in Vitamin K in infancy. eds Sutor AH Hathaway WE (Schattauer, Stuttgart), pp 395\u2013401.","key":"2025090510103418000_81.3.F208.14"},{"key":"2025090510103418000_81.3.F208.15","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/S0140-6736(72)92209-X","article-title":"Maternal epilepsy and abnormalities of the fetus and newborn.","volume":"ii","author":"Speidel","year":"1972","journal-title":"Lancet"},{"doi-asserted-by":"publisher","key":"2025090510103418000_81.3.F208.16","DOI":"10.1016\/S0022-3476(85)80656-9"},{"unstructured":"Sutor AH (1995) Vitamin K deficiency bleeding in infancy: a status report. in Vitamin K in Infancy. eds Sutor AH Hathaway WE (Schattauer, Stuttgart), pp 3\u201318.","key":"2025090510103418000_81.3.F208.17"},{"key":"2025090510103418000_81.3.F208.18","first-page":"1","article-title":"Morbus hemorrhagicus neonatorum. (Hypoprothrombinemia neonatorum).","volume":"27 (suppl 1)","author":"Salomonsen","year":"1939","journal-title":"Acta Paediatr Scand"},{"doi-asserted-by":"publisher","key":"2025090510103418000_81.3.F208.19","DOI":"10.1016\/S0140-6736(00)74175-4"},{"key":"2025090510103418000_81.3.F208.20","first-page":"506","article-title":"Haemorrhage in the newborn. 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(Royal College of Physicians, London).","key":"2025090510103418000_81.3.F208.26"},{"key":"2025090510103418000_81.3.F208.27","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1136\/bmj.316.7126.178","article-title":"Case-control studies of relation between childhood cancer and neonatal vitamin K administration.","volume":"316","author":"Passmore","year":"1998","journal-title":"BMJ"},{"key":"2025090510103418000_81.3.F208.28","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1136\/adc.79.4.295","article-title":"The vitamin K debacle: cut the Gordian knot but first do no harm.","volume":"79","author":"Tripp","year":"1998","journal-title":"Arch Dis Child"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fn.81.3.F208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T17:13:19Z","timestamp":1757092399000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fn.81.3.F208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,11,1]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1999,11,1]]},"published-print":{"date-parts":[[1999,11,1]]}},"alternative-id":["10.1136\/fn.81.3.F208"],"URL":"https:\/\/doi.org\/10.1136\/fn.81.3.f208","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"type":"print","value":"1359-2998"},{"type":"electronic","value":"1468-2052"}],"subject":[],"published":{"date-parts":[[1999,11,1]]}}}