Hyperemesis gravidarum and vitamin K deficiency: a systematic review
Kelly Nijsten, Loïs M. van der Minnen, Hanke M.G. Wiegers, Marjette H. Koot, Saskia Middeldorp, Tessa J. Roseboom, Iris J. Grooten, Rebecca C. Painter
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.