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Late hemorrhagic disease of newborn
1Department of Pediatrics, St. John's Medical College Hospital, Bangalore, Karnataka, India.
Insights
Late hemorrhagic disease of the newborn (LHDN) severely affects exclusively breast-fed infants. Vitamin K prophylaxis is crucial for preventing this serious condition and its potentially fatal outcomes.
Area of Science:
- Neonatology
- Pediatric Hematology
- Public Health
Background:
- Late hemorrhagic disease of the newborn (LHDN) is a serious bleeding disorder in infants.
- Exclusively breast-fed infants are particularly vulnerable.
- Vitamin K deficiency is a primary cause of LHDN.
Purpose of the Study:
- To describe the clinical characteristics of infants with late hemorrhagic disease of the newborn.
- To highlight the association between lack of vitamin K prophylaxis and LHDN.
- To emphasize the importance of vitamin K administration in preventing LHDN.
Main Methods:
- Retrospective case series of 14 infants diagnosed with LHDN.
- Review of clinical presentations, physical examination findings, and diagnostic tests (CT scans).
- Analysis of vitamin K prophylaxis status and underlying health conditions.
Main Results:
- 93% of infants presented with intracranial bleeding.
- Common symptoms included seizures (71%) and vomiting (57%).
- 57% of affected infants died, and 36% experienced neurological sequelae.
Conclusions:
- Late hemorrhagic disease of the newborn results in high mortality and morbidity.
- Lack of vitamin K prophylaxis is a significant risk factor.
- Universal vitamin K prophylaxis for all newborns is essential for prevention.
Abstract:
The clinical features of 14 infants diagnosed with late hemorrhagic disease of newborn (LHDN), of which 10 did not receive vitamin K prophylaxis, are presented. All infants were exclusively breast-fed and 12 did not have any underlying illness to explain the abnormal coagulation profile. The common presenting symptoms were seizures (71%), vomiting (57%), poor feeding (50%) and altered sensorium (36%). Physical examination shared pallor in all infants and a bulging anterior fontanel in 64%. Intracranial bleed was the predominant manifestation (93%), with CT scan showing intracranial bleed in 78%. Eight infants (57%) succumbed to their illness, while 36%had neurological sequelae. Since LHDN leads to significant morbidity and mortality, it should be prevented by providing vitamin K prophylaxis to all newborns.
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