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Prophylaxis of vitamin K deficiency in infancy
T Nakagawa1, T Yazawa, K Watanabe
1Vitamin K Study Group, Okazaki City Medical Doctors Association, Japan.
Insights
This study compared two vitamin K administration methods for infants to prevent deficiency. Prophylactic vitamin K at birth and one week, along with risk factor identification, is recommended for effective infant vitamin K deficiency prophylaxis.
Area of Science:
- Pediatrics
- Neonatology
- Public Health
Background:
- Vitamin K deficiency in infancy (VKDI) poses a significant health risk.
- Existing prophylaxis methods may not be universally effective.
- Identifying risk factors is crucial for targeted interventions.
Purpose of the Study:
- To evaluate the effectiveness of two different vitamin K administration strategies for preventing VKDI.
- To identify risk factors associated with vitamin K deficiency in infants.
Main Methods:
- A prospective study comparing non-prophylactic vitamin K administration (NPVK) with prophylactic vitamin K (PVK) in 5,431 infants.
- Normotest (Hepaplastintest) was used to assess vitamin K levels at one week and one month of age.
- Risk factors including month of birth, maternal age, birth order, and infant sex were analyzed.
Main Results:
- Both NPVK and PVK groups showed instances of low Normotest values at one month.
- Low Normotest values were observed in 20 out of 2,791 infants in the NPVK group.
- Low Normotest values were observed in 20 out of 2,640 infants in the PVK group.
Conclusions:
- Prophylactic vitamin K administration at birth and one week, with potential repeat at one month based on Normotest, appears more effective.
- Month of birth (June-September), maternal age (21-29 years), first-born status, and male sex are identified as risk factors for VKDI.
Abstract:
A prospective study was performed in Okazaki, Japan, to attempt to establish a more effective system of prophylaxis for vitamin K deficiency in infancy (VKDI). During the first year, a Normotest (Hepaplastintest) was performed in all infants at one week and at one month of age. Two mg of vitamin K was administered orally to those whose Normotest values were below 40%. i.e., the non-prophylactic administration of vitamin K (NPVK). During the second year of the study, all newborn infants received prophylactic vitamin K (PVK) within 24 hours of birth and at one week of age. The dosage was repeated at one month of age depending on the Normotest value. A total of 7,059 infants, comprising 93.3% of the live births in the city of Okazaki, were enrolled in this study. Data from 5,431 of these infants were used in the analysis of the results. In the NPVK group, 20 of the 2,791 infants had Normotest values below 40% at one month of age while 20 of the 2,640 in the PVK group had low values despite the prophylactic administration of vitamin K. Considering the prevalence of low Normotest values (less than or equal to 40%) at one month of age and the predicted Normotest values, it was concluded that the month of birth (June-September), the age of the mother (21-29 years), the birth order (first-born) and male sex are risk factors for vitamin K deficiency in infancy.