Perinatal influences on the uptake of newborn Vitamin K prophylaxis – a retrospective cohort study

Burke, M S; Bernhardt, Helen; Reith, David; Barker, David; Broadbent, Roland; Wheeler, Benjamin J

doi:10.1111/1753-6405.12399

Cited by 13 publications

(24 citation statements)

References 14 publications

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“…This issue has also been seen with regard to paediatric immunisation and NBS 24 25. It has been recently speculated that this may be one possible contributing reason for an association linking Asian/Indian ethnicity to uptake of oral vitamin K 12. Interestingly, two of the three participants in our study of Asian/Indian ethnicity, raised this as an issue.…”

Section: Discussionsupporting

confidence: 61%

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Why do parents decline newborn intramuscular vitamin K prophylaxis?

et al. 2016

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Section: Discussionsupporting

confidence: 61%

“…Supporting this, a range of studies have now associated refusing intramuscular vitamin K with factors aligned with parental or health professional preferences/attitudes towards natural birth 11 12 16. This highlights the importance of appropriate education of families.…”

Section: Discussionmentioning

confidence: 95%

Why do parents decline newborn intramuscular vitamin K prophylaxis?

et al. 2016

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“…Large-scale surveillance studies similar to those from New Zealand 10 and Canada 6 are needed in the United States to better quantify the problem. More in-depth, qualitative studies of parents who refuse IM vitamin K are needed to better understand attitudes and beliefs.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,7,8 In large-scale surveillance studies on vitamin K refusal in New Zealand and Canada, the authors reported refusals rates of 1.7% and 0.5%, respectively. 6,10 There is a paucity of data on vitamin K refusal rates in the United States; the only reports are from single centers. There have been no large-scale, multisite studies in the United States about the scope of the problem of vitamin K refusal, approaches to refusal from the newborn clinician perspective, or regional variation in this phenomenon.…”

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confidence: 99%

Refusal of Vitamin K by Parents of Newborns: A Survey of the Better Outcomes Through Research for Newborns Network

Loyal

Taylor

Phillipi

et al. 2017

Academic Pediatrics

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Objective To survey newborn clinicians in the United States regarding the frequency of intramuscular (IM) vitamin K refusal by a parent, reasons for refusal, and approaches of clinicians to refusals. Methods An electronic survey was administered to the clinician site representative (nursery director or designee knowledgeable about site-specific nursery policies) at all newborn nurseries in the Better Outcomes through Research for Newborns (BORN) network of newborn nurseries. Results Of 92 BORN sites, 85 (92%) respondents completed the survey. Frequency of IM vitamin K refusal during the past 5 years was reported as increased by 52% of respondents, unchanged by 42%, and 6% did not know. Reported frequencies of refusal of IM vitamin K was weekly (9%), a few times a month (31%), once a month (13%), once every 3 to 4 months (20%), once or twice a year (26%), or never (1%). The overall distribution of the reported frequencies of refusal differed among regions in the United States (higher in the West and the South; P < .05). Reported reasons for refusal by parents included perceptions of parents that the injection was unnecessary, lack of knowledge about vitamin K deficiency bleeding, and concern about preservatives. Approaches to refusal included attempts to educate parents, enlisting support from community clinicians, a state mandate, and prescription of oral vitamin K. Conclusions Respondents from a national sample of newborn nursery clinicians reported an increase in refusal of IM vitamin K in the past 5 years with regional variation. Approaches to refusals need further investigation to determine effectiveness.

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“…Conflicting impressions or lack of confidence perceived by patients from different healthcare providers about early‐life public health interventions can further negatively impact uptake. Highly skewed proportions of women rejecting the intramuscular dose have been found to be receiving care from the same maternity health professional personnel, suggestive of meaningful negative influence on parental decision making …”

Section: Discussionmentioning

confidence: 99%

The hepatitis B birth‐dose immunisation: Exploring parental refusal

Gilmartin

Daley

Leung

2019

Aust NZ J Obst Gynaeco

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Background Hepatitis B virus (HBV) immunisation is the first vaccine of infant life and one of the most commonly refused immunisations on the Australian Immunisation Schedule. Aims To quantify the frequency of declined HBV immunisation birth‐doses, investigate reasons for refusal, and determine information sources used by parents. Materials and Methods A cross‐sectional study using a questionnaire was conducted on postnatal women who declined their newborn's HBV birth‐dose immunisation during December 2016–July 2017 at an Australian tertiary referral hospital. Mothers who were non‐English‐speaking, unwell or medically unstable, or otherwise unavailable were excluded. Results One hundred and thirty‐seven of the 1574 (8.7%) eligible reviewed infants had HBV immunisation birth‐doses documented as declined; 113 mothers consented to complete the questionnaire. The most common reasons for declining the dose were: ‘baby too young’ (55.8%); preference for two, four and six‐month HBV immunisations only (56.6%); perceived low risk of contracting HBV (45.1%); and a fear of ‘overloading’ their baby's immune system (42.5%). General practitioners or nurses/midwives (43.3%) and the internet/media (33.6%) were the predominant information sources consulted, and 58.4% felt satisfied with the information they received antenatally. Eighty‐eight of 113 mothers (77.9%) would still consider future immunisations for their infant. Conclusions The majority of postnatal women decline HBV birth‐dose immunisation for their newborns citing age‐related safety concerns and vaccine misconceptions. Informal information sources such as the internet and media are often consulted. Addressing the need for antenatal and health professional education toward the birth‐dose may be instrumental in improving uptake.

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Perinatal influences on the uptake of newborn Vitamin K prophylaxis – a retrospective cohort study

Cited by 13 publications

References 14 publications

Why do parents decline newborn intramuscular vitamin K prophylaxis?

Why do parents decline newborn intramuscular vitamin K prophylaxis?

Refusal of Vitamin K by Parents of Newborns: A Survey of the Better Outcomes Through Research for Newborns Network

The hepatitis B birth‐dose immunisation: Exploring parental refusal

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