PhD student Karolinska Institute Stockholm, Stockholms Lan, Sweden
Background: Vitamin K deficiency bleeding (VKDB) in the newborn is a rare but a potentially fatal bleeding disorder which can be prevented by vitamin K prophylaxis at birth. However, an increasing trend of parental refusal to administration of vitamin K prophylaxis has been reported from many countries. This trend is paralleled by a rise in the incidence of late onset VKDB. Objective: The aim of this study was to examine potential changes over time in the prevalence of administration of vitamin K prophylaxis in newborns in Sweden and of bleedings, during the neonatal period and infancy. Design/Methods: In this nationwide cohort study, we included all live born (>= 35+0 gestational weeks) births in Sweden between January 1, 2003 to December 31, 2019. Data retrieved from the Swedish Medical Birth Register and the National Patient Register were linked on the individual level. Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). The exposure of non-administered vitamin K was defined by a check box for vitamin K administration in the Medical Birth Register. The outcome was defined as any diagnosis of bleeding within 6 months after birth, according to the International Classification of Diseases (ICD-10) diagnosis in the Patient and Medical Birth Registers. Results: Out of the 1 798 575 births included in the study, 18 685 (1.04%) newborns did not get Vitamin K prophylaxis (0.90 % 2003-2011 and 1.18% 2012-2019). There were regional variations with higher frequency of non-administrated Vitamin K in some counties: Norrbotten (5.7%) and Uppsala (3.54%), and lowest frequency in Kronoberg and Västmanland county (0.52%). Infants who did not receive Vitamin K had 3.75-fold (OR, CI:2.57-5.47) higher odds of VKDB up to 4 weeks after birth compared with those who received vitamin K at birth. Compared with infants who received vitamin K prophylaxis, those who did not had 2.29-fold higher odds (95% CI:1.7-3.09) of hospitalization due to bleeding within the first 6 months of life.
Conclusion(s): In Sweden, the number of cases of non-administrating Vitamin in newborns is low but increasing and infants who had not received vitamin K had a significantly higher risk of a bleeding diagnosis and to be admitted to inpatient care. Our results are in line with similar studies from other countries and confirm the importance of vitamin K administration in the newborn period to prevent neonatal and infant bleedings.
.jpeg.jpg "Eleni Simatou (she/her/hers) photo")