Prophylactic vitamin K refusal may have adverse consequences for newborns

The number of infants not receiving intramuscular vitamin K to prevent bleeding episodes is increasing, and this translates to an increased risk of bleeding episodes, including intracranial haemorrhages, according to a nationwide cohort study from Sweden.

The study included 2,020,302 live-born infants delivered at ≥35 weeks of gestation between 2003 and 2021. Researchers used data from the Swedish Medical Birth Register to determine a bleeding diagnosis within the first 6 months of life, the primary outcome.

Of the infants, 24,089 (mean gestational age 40 weeks, 51.8 percent male) had no record of intramuscular vitamin K administration at birth. The number of infants who did not receive prophylactic vitamin K dropped from 1.32 percent in 2003 to 0.66 percent in 2006 and then gradually increased and more than doubled to 1.50 percent in 2021.

Compared infants who received intramuscular vitamin K at birth, those who did not receive it had 52-percent increased odds of bleeding during infancy (adjusted odds ratio [aOR], 1.52, 95 percent confidence interval [CI], 1.27–1.81).

The odds of an intracranial bleeding were especially high, increasing threefold among those who did not receive prophylactic vitamin K (aOR, 2.91, 95 percent CI, 2.13–3.96).

The findings underscore the importance of intramuscular vitamin K administration in newborns to prevent bleeding episodes, the researchers said. Parents and caregivers must receive education on its significance.