Canadian Paediatric Surveillance Program confirms low incidence of hemorrhagic disease of the newborn in Canada

McMillan, Douglas; Grenier, Danielle; Medaglia, Andrea

doi:10.1093/pch/9.4.235

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…The surveillance method used is similar to other countries 16. The overall annual incidence of VKDB in Australia, at 0.84 per 100 000 live births, is comparable to rates reported in countries where 1 mg intramuscular or the three 2 mg oral dosing regimens were used, although international comparison is limited by slightly different surveillance methods and timing of studies 12 13 20–22…”

Section: Discussionmentioning

confidence: 58%

“…Of the seven cases of late VDKB following 1 mg intramuscular vitamin K, three had confirmed liver or biliary disease, which is associated with prophylactic failure,11 but four exclusively breastfed infants without other risk factors had VKDB after 1 mg intramuscular vitamin K prophylaxis. Prophylaxis failure has been reported in healthy breastfed infants 21 34. Exclusive breastfeeding is widely recommended until 6 months of age,35 so the relationship between breastfeeding, mothers’ nutritional status and VKDB in infants who received intramuscular vitamin K at birth warrants further investigation.…”

Section: Discussionmentioning

confidence: 99%

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Vitamin K deficiency bleeding in Australian infants 1993–2017: an Australian Paediatric Surveillance Unit study

Zurynski¹,

Grover

Jalaludin³

et al. 2019

Arch Dis Child

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ObjectiveTo undertake surveillance of vitamin K deficiency bleeding (VKDB) in Australia from 1993 to 2017, during a time of change to national recommendations and available vitamin K formulations.MethodsPaediatricians reported cases of VKDB in infants aged <6 months and provided demographic, clinical and biochemical information via the Australian Paediatric Surveillance Unit.Results58 cases were reported, of which 5 (9%) were early, 11 (19%) classic and 42 (72%) late VKDB. 53 (91%) were exclusively breast fed. Seven (12%) received oral prophylaxis, the majority (86%) of whom did not receive all three recommended doses. The overall reported incidence was 0.84 per 100 000 live births (95% CI: 0.64 to 1.08) and the incidence of late VKDB was 0.61 per 100 000 live births (95% CI: 0.44 to 0.82), which are similar to rates reported by other countries where intramuscular vitamin K is recommended. VKDB rates were significantly higher (2.46 per 100 000 live births; 95% CI: 1.06 to 4.85) between 1993 and March 1994 when oral prophylaxis was recommended (p<0.05). Vitamin K was not given to 33 (57%) cases, primarily due to parental refusal, and the number of parental refusals increased significantly after 2006 (p<0.05). There were six deaths, all due to intracranial haemorrhage, and three associated with home delivery and parental refusal of vitamin K.ConclusionsIncidence rates of VKDB in Australia are among the lowest in the world; however, we have identified an increasing trend of parental refusal. Ongoing surveillance and educational campaigns for health professionals and parents are needed to prevent VKDB.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Vitamin K deficiency bleeding in Australian infants 1993–2017: an Australian Paediatric Surveillance Unit study

Zurynski¹,

Grover

Jalaludin³

et al. 2019

Arch Dis Child

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“…The overall incidence of confirmed classic cases was 1.24 per 100 000 births and 1.55 per 100 000 births if the two probable cases are included. Comparing this with the incidence of classic VKDB from overseas is complicated by differences in the chosen denominator, but recent figures from other developed countries range from 0.08 to 5.4 per 100 000 births 17,18 . A meaningful denominator is births where no vitamin K was given, but national data on vitamin K prophylaxis uptake are not known.…”

Section: Discussionmentioning

confidence: 99%

New Zealand surveillance of neonatal vitamin K deficiency bleeding (VKDB): 1998–2008

Darlow

Phillips

Dickson

2011

J Paediatrics Child Health

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“…Reports from the Canadian Paediatric Surveillance Program (CPSP) between 1997 and 2000 confirmed five cases of late VKDB, including one infant who received no vitamin K and two who received PO vitamin K, yielding an estimated incidence of 1 per 140,000 to 170,000 births (24).…”

Section: Prevention Of Late Vkdbmentioning

confidence: 99%

Guidelines for vitamin K prophylaxis in newborns

Loewy

2018

Paediatrics &Amp; Child Health

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A joint statement with the College of Family Physicians of CanadaAll Canadian Paediatric Society position statements and practice points are reviewed regularly and revised as needed. Consult the Position Statements section of the CPS website www.cps.ca/en/documents for the most current version. Retired statements are removed from the website. AbstractNewborns are at risk for vitamin K deficiency bleeding (VKDB) caused by inadequate prenatal storage and deficiency of vitamin K in breast milk. Systematic review of evidence to date suggests that a single intramuscular (IM) injection of vitamin K at birth effectively prevents VKDB. Current scientific data suggest that single or repeated doses of oral (PO) vitamin K are less effective than IM vitamin K in preventing VKDB. The Canadian Paediatric Society and the College of Family Physicians of Canada recommend routine IM administration of a single dose vitamin K at 0.5 mg to 1.0 mg to all newborns. Administering PO vitamin K (2.0 mg at birth, repeated at 2 to 4 and 6 to 8 weeks of age), should be confined to newborns whose parents decline IM vitamin K. Health care providers should clarify with parents that newborns are at increased risk of VKDB if such a regimen is chosen. Current evidence is insufficient to recommend routine intravenous vitamin K administration to preterm infants undergoing intensive care.

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Canadian Paediatric Surveillance Program confirms low incidence of hemorrhagic disease of the newborn in Canada

Cited by 11 publications

References 18 publications

Vitamin K deficiency bleeding in Australian infants 1993–2017: an Australian Paediatric Surveillance Unit study

Vitamin K deficiency bleeding in Australian infants 1993–2017: an Australian Paediatric Surveillance Unit study

New Zealand surveillance of neonatal vitamin K deficiency bleeding (VKDB): 1998–2008

Guidelines for vitamin K prophylaxis in newborns

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