The Indian Journal of Pediatrics

, Volume 72, Issue 3, pp 205–207 | Cite as

Relationship between serum bilirubin and coagulation test results in 1-month-old infants

  • Filiz Tiker
  • Berkan Gürakan
  • Aylin Tarcan
Original Article


Objective: Although the connection between cholestasis and conjugated hyperbilirubinemia is well known, mild hepatic dysfunction or cholestasis may also be associated with unconjugated hyperbilirubinemia in some infants with prolonged jaundice. The aim of this study was to investigate the relationship between serum bilirubin levels and alanine aminotransferase levels, asparte aminotransferase levels, prothrombin time, activated partial thromboplastin time and international normalization ratio findings in a group of infants.Methods: The study included 77 healthy, term, breast-fed infants with jaundice and 56 age-matched, healthy, term, non-jaundiced controls. The 133 babies were divided into three subgroups according to their total bilirubin levels [group I (controls) <50 μmol/L, group II=50–100 μmol/L, and group III >100 μmol/L, and the findings for the noted parameters were compared].Results: The mean conjugated bilirubin level was significantly higher, and the mean activated partial thromboplastin time significantly longer in group III than in group I. A significant positive correlation was found between bilrubin levels and PT and APTT results.Conclusion: Clinical vitamin K deficiency appeared unlikely to develop in this group of infants with prolonged unconjugated hyperbilirubinemia. However, a significant positive correlation between bilirubin levels and PT and APTT suggest that a higher bilirubin load to the liver may cause some degree of vitamin K deficiency due to mild cholestasis. The importance of this finding, and the possible benefits of vitamin K supplementation in 1-month-old breast-fed infants with bilirubin levels higher than 100 μmol/L require further investigation.

Key words

Cholestasis Coagulation Vitamin K deficiency Prolonged unconjugated hyperbilirubinemia 


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  1. 1.
    Hannam S, McDonnell M, Rennie JM. Investigation of prolonged neonatal jaundice.Acta Pediatr 2000; 89: 694–697.CrossRefGoogle Scholar
  2. 2.
    Tazawa Y, Yamada M, Nakagawa M, Konno T, Tada K. Serum bile acids and their conjugates in breast-fed infants with prolonged jaundice.Eur J Pediatr 1985; 144: 37–40.CrossRefPubMedGoogle Scholar
  3. 3.
    Yamada M, Tazawa Y, Nakagawa Met al. Alterations of serum bile acid profile in breast-fed infants with prolonged jaundice.J Pediatr Gastroenterol Nutr 1985; 4: 741–745.CrossRefPubMedGoogle Scholar
  4. 4.
    Tazawa Y, Abukawa D, Watabe M, Nakagawa M, Yamada M. Abnormal results of biochemical liver function tests in breastfed infants with prolonged indirect hyperbilirubinemia.Eur J Pediatr 1991; 150: 310–313.CrossRefPubMedGoogle Scholar
  5. 5.
    Greer FR. Vitamin K status of lactating mothers and their infants.Acta Pediatr Suppl 1999; 430: 95–103.CrossRefGoogle Scholar
  6. 6.
    Motohara K, Matsukuro M, Matsuda Iet al. Severe vitamin K deficiency in breast-fed infants.J Pediatr 1984; 105: 943–945.CrossRefPubMedGoogle Scholar
  7. 7.
    Sutor AH, von Kries R, Cornelissen EAM, McNinch AW, Andrew M. Vitamin K deficiency bleeding (VKDB) in infancy.Thromb Haemost 1999; 81: 456–461.PubMedGoogle Scholar
  8. 8.
    Zipursky A. Prevention of vitamin K deficiency bleeding in newborns.Br J Haematol 1999; 104: 430–437.CrossRefPubMedGoogle Scholar
  9. 9.
    Loughnan PM, McDougall PN. Epidemiology of late onset haemorrhagic disease: a pooled data analysis.J Pediatr Child Health 1993; 29: 177–181.CrossRefGoogle Scholar
  10. 10.
    Andrew M. The relevance of developmental hemostasis to hemorrhagic disorders of newborns.Seminars Perinatol 1997; 21: 70–85.CrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2005

Authors and Affiliations

  • Filiz Tiker
    • 1
  • Berkan Gürakan
    • 1
  • Aylin Tarcan
    • 1
  1. 1.Faculty of Medicine, Department of PediatricsBaskent UniversityTurkey

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