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Comparative study of oral versus injectable vitamin K in neonates
S Malik1, R H Udani, S K Bichile
1Department of Pediatrics and Hematology, T.N.M. College, Bombay.
Insights
Oral Vitamin K is as effective as injectable Vitamin K for preventing hemorrhagic disease of newborn (HDN). This study recommends oral Vitamin K due to its comparable efficacy and lower cost.
Area of Science:
- Pediatrics
- Neonatology
- Pharmacology
Background:
- Hemorrhagic disease of the newborn (HDN) is a preventable condition.
- Vitamin K prophylaxis is standard for newborns.
- Different administration routes and doses of Vitamin K are used.
Purpose of the Study:
- To evaluate the efficacy of various Vitamin K administration modes and doses.
- To compare intramuscular versus oral Vitamin K for preventing HDN.
- To determine the optimal Vitamin K regimen for exclusively breastfed infants.
Main Methods:
- A study involving 100 exclusively breastfed infants weighing over 2.5 kg.
- Infants were divided into four groups: 1 mg IM Vitamin K, 0.5 mg IM Vitamin K, 1 mg oral Vitamin K, and no Vitamin K.
- Prothrombin index was measured between 36-72 hours of age.
Main Results:
- Infants receiving Vitamin K (Groups A, B, C) showed significantly higher prothrombin indices compared to the no-Vitamin K group (Group D).
- Prothrombin indices for 1 mg IM, 0.5 mg IM, and 1 mg oral Vitamin K were statistically similar.
- The no-Vitamin K group exhibited a significantly reduced prothrombin index (80.39 +/- 15.90%).
Conclusions:
- Oral Vitamin K is as effective as intramuscular Vitamin K in preventing hemorrhagic disease of the newborn.
- The study recommends oral Vitamin K administration to reduce complications and costs associated with parenteral therapy.
- Vitamin K prophylaxis is crucial for exclusively breastfed infants to maintain adequate coagulation.
Abstract:
One hundred term exclusively breast fed babies weighing more than 2.5 kg were evaluated to determine the efficacy of various modes and doses of Vitamin K to prevent hemorrhagic disease of newborn (HDN). The babies were grouped into four categories of 25 each: Group A--1 mg Vitamin K intramuscular (Menadione sodium disulphite) at birth; Group B--0.5 mg Vitamin K intramuscular; Group C--1 mg Vitamin K orally, and group D--no Vitamin K. The prothrombin index was estimated in all babies between 36-72 hours of age. The results revealed a prothrombin index in Groups A, B, C and D as 94.98 +/- 7.64%, 95.08 +/- 9.91%, 92.51 +/- 10.10% and 80.39 +/- 15.90%, respectively. The differences between Groups A, B and C were insignificant. However, Group D, prothrombin index was significantly reduced as compared with the other three groups. It is, therefore, concluded that oral Vitamin K is as effective as injectable Vitamin K and its usage is recommended in our country to reduce complications and costs of parenteral therapy.