Absorption, Metabolism, and Storage of K Vitamins in the Newborn

  • Martin J. Shearer
Conference paper


The fetal and neonatal physiology and biochemistry of vitamin K is probably the least understood of all the fat-soluble vitamins. Major questions surround the transplacental transfer, intestinal absorption, intermediary metabolism, plasma transport, bioavailability, storage, and turnover of the K vitamins. Such questions include the relative importance to fetal and neonatal requirements of phylloquinone (vitamin K1), the plant synthesized form of vitamin K, and the menaquinones (vitamin K2), which are of bacterial origin. For example, the establishment of an intestinal flora which synthesize menaquinones is known to occur in the first few days of life, but the role of enteric menaquinones as a potential source of vitamin K in neonates remains as controversial a question as it does in adults.


Bile Salt Mixed Micelle Exocrine Pancreatic Insufficiency Cord Plasma Liver Store 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Shearer MJ, Rahim S, Barkhan P, Stimmler L (1982) Plasma vitamin K1 in mothers and their newborn babies. Lancet II: 460–463Google Scholar
  2. 2.
    Shearer MJ (1983) High-performance liquid chromatography of K vitamins and their antagonists. Adv Chromatogr 21: 243–301PubMedGoogle Scholar
  3. 3.
    Lefevere MF, De Leenheer AP, Claeys AE, Claeys IV, Steyaert H (1982) Multidimensional liquid chromatography: a breakthrough in the assessment of physiological vitamin K levels. J Lipid Res 23: 1068–1072PubMedGoogle Scholar
  4. 4.
    Haroon Y, Schubert CAW, Hauschka PV (1984) Liquid chromatographic dual electrode detection system for vitamin K compounds. J Chromatogr Sci 22: 89–93PubMedGoogle Scholar
  5. 5.
    Hart JP, Shearer MJ, McCarthy PT (1985) Enhanced sensitivity for the determination of endogenous phylloquinone (vitamin K1) in plasma using high-performance liquid chromatography with dual-electrode electrochemical detection. Analyst 110: 1181–1184PubMedCrossRefGoogle Scholar
  6. 6.
    Langenberg JP, Tjaden UR (1984) Determination of (endogenous) vitamin K1 in human plasma by reversed-phase high performance liquid chromatography using fluorometric detection after post-column electrochemical reduction: comparison with ultraviolet, single and dual electrochemical detection. J Chromatogr 305: 61–72PubMedCrossRefGoogle Scholar
  7. 7.
    Lambert WE, De Leenheer AP, Lefevere MF (1986) Determination of vitamin K in serum using HPLC with post-column reaction and fluorescence detection. J Chromatogr Sci 24: 76–79PubMedGoogle Scholar
  8. 8.
    Haroon Y, Bacon DS, Sadowski JA (1986) Liquid-chromatographic determination of vitamin K1 in plasma with fluorometric detection. Clin Chem 32: 1925–1929PubMedGoogle Scholar
  9. 9.
    Shearer MJ, McBurney A, Barkhan P (1974) Studies on the absorption and metabolism of phylloquinone (vitamin K1 in man. Vitam Horm 32: 513–542PubMedCrossRefGoogle Scholar
  10. 10.
    Hollander D (1981) Intestinal absorption of vitamins A, E, D and K. J Lab Clin Med 97: 449–462PubMedGoogle Scholar
  11. 11.
    Hofmann AF (1966) A physicochemical approach to the intraluminal phase of fat absorption. Gastroenterology 50: 56–64PubMedGoogle Scholar
  12. 12.
    Evans WB, Wollaeger EE (1966) Incidence and severity of nutritional deficiency states in chronic exocrine pancreatic insufficiency: comparison with nontropical sprue. Am J Dig Dis 11: 594–606PubMedCrossRefGoogle Scholar
  13. 13.
    Nagata M, Yotsuyanagi T, Ikeda K (1988) Solubilization of vitamin K1 by bile salts and phosphatidylcholine-bile salt mixed micelles. J Pharm Pharmacol 40: 85–88PubMedCrossRefGoogle Scholar
  14. 14.
    McNinch AW, Upton C, Samuels M, Shearer MJ, McCarthy P, Tripp JH, Orme RL’E (1985) Plasma concentrations after oral or intramuscular vitamin K1 in neonates. Arch Dis Child 60: 814–818PubMedCrossRefGoogle Scholar
  15. 15.
    Shinzawa T, Mura T, Tsunei M, Shiraki K (1989) Vitamin K absorption capacity and its association with vitamin K deficiency. Am J Dis Child 143: 686–689PubMedGoogle Scholar
  16. 16.
    Park BK, Scott AK, Wilson AC, Haynes BP, Breckenridge AM (1984) Plasma disposition of vitamin K1 in relation to anticoagulant poisoning. Br J Clin Pharmacol 18: 655–662PubMedCrossRefGoogle Scholar
  17. 17.
    Von Kries R, Reifenhäuser A, Göbel U, McCarthy P, Shearer MJ, Barkhan P (1985) Late onset haemorrhagic disease of newborn with temporary malabsorption of vitamin K1. Lancet I: 1035Google Scholar
  18. 18.
    Matsuda I, Nishiyama S, Motohara K, Endo F, Ogata T, Futagoishi Y (1989) Late neonatal vitamin K deficiency associated with subclinical liver dysfunction in human milk-fed infants. J Pediatr 114: 602–605PubMedCrossRefGoogle Scholar
  19. 19.
    Mandelbrot L, Guillaumont M, Leclercq M, Lefrère JJ, Gozin D, Daffos F, Forestier F (1988) Placental transfer of vitamin K1 and its implications in fetal hemostasis. Thromb Haemost 60: 39–43PubMedGoogle Scholar
  20. 20.
    Pietersma-de Bruyn ALJM, Van Haard PMM (1985) Vitamin K1 in the newborn. Clin Chim Acta 150: 95–101CrossRefGoogle Scholar
  21. 21.
    Sann L, Leclercq M, Guillaumont M, Trouyez R, Bethenod M, Bourgeay-Causse M (1985) Serum vitamin K1 concentrations after oral administration of vitamin K1 in low birth weight infants. J Pediatr 107: 608–611PubMedCrossRefGoogle Scholar
  22. 22.
    Greer FR, Mummah-Schendel LL, Marshall S, Suttie JW (1988) Vitamin K1 (phyllo-quinone) and vitamin K2 (menaquinone) status in newborns during the first week of life. Pediatrics 81: 137–140PubMedGoogle Scholar
  23. 23.
    Hiraike H, Kimura M, Itokawa Y (1988) Distribution of K vitamins (phylloquinone and menaquinones) in human placenta and maternal and umbilical cord plasma. Am J Obstet Gynecol 158: 564–569PubMedGoogle Scholar
  24. 24.
    Widdershoven J, Lambert W, Motohara K, Monnens L, De Leenheer A, Matsuda I, Endo F (1988) Plasma concentrations of vitamin Ki and PIVKA-II in bottle-fed and breast-fed infants with and without vitamin K prophylaxis at birth. Eur J Pediatr 148: 139–142PubMedCrossRefGoogle Scholar
  25. 25.
    Yang Y-M, Simon N, Maertens P, Brigham S, Liu P (1989) Maternal-fetal transport of vitamin K1 and its effects on coagulation in premature infants. J Pediatr 115: 1009–1013PubMedCrossRefGoogle Scholar
  26. 26.
    Shearer MJ, McCarthy PT, Crampton OE, Mattock MB (1988) The assessment of human vitamin K status from tissue measurements. In: Suttie JW (ed) Current advances in vitamin K research. Elsevier, New York, pp 437–452Google Scholar
  27. 27.
    De Leenheer AP, Nelis HJ, Lambert WE, Bauwens RM (1988) Chromatography of fat-soluble vitamins in clinical chemistry. J Chromatogr 429: 3–58PubMedCrossRefGoogle Scholar
  28. 28.
    Kayata S, Kindberg C, Greer FR, Suttie JW (1989) Vitamin K1 and K2 in infant human liver. J Pediatr Gastroenterol Nutr 8: 304–307PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Martin J. Shearer
    • 1
  1. 1.Haematology Research Laboratory, Clinical Science Laboratories, Guys Tower (18th Floor)Guys HospitalLondonUK

Personalised recommendations