Vitamin K deficiency bleeding (VKDB) in early infancy

Area of Science:

• Pediatrics
• Neonatology
• Hematology

Background:

• Vitamin K deficiency bleeding (VKDB) is a rare but severe bleeding disorder in infants.
• Infants are born with low vitamin K stores, and breast milk has low concentrations, increasing risk.
• Classical VKDB occurs in the first week, while late VKDB (3-8 weeks) often involves intracranial hemorrhage due to malabsorption.

Purpose of the Study:

• To review the epidemiology, diagnosis, and prevention of Vitamin K deficiency bleeding (VKDB).
• To highlight the effectiveness of different vitamin K prophylaxis strategies.

Main Methods:

• Review of existing literature on VKDB incidence, risk factors, and prevention.
• Discussion of diagnostic methods, including PIVKA-II measurements.
• Analysis of the efficacy of oral versus parenteral vitamin K prophylaxis.

Main Results:

• Late VKDB incidence is higher in Southeast Asia compared to Europe without prophylaxis.
• Parenteral vitamin K offers the best protection against VKDB.
• Oral prophylaxis efficacy varies with dose and frequency, with some infants with undetected liver disease remaining at risk.

Conclusions:

• Vitamin K deficiency bleeding (VKDB) is largely preventable with appropriate vitamin K administration.
• Parenteral vitamin K prophylaxis is superior to oral routes for comprehensive protection.
• Targeted surveillance of high-risk infants is a potential strategy to improve prophylaxis efficacy.