Neonatal vitamin K refusal and nonimmunization.

Area of Science:

• Pediatrics
• Public Health
• Epidemiology

Background:

• Neonatal Vitamin K prophylaxis prevents vitamin K deficiency bleeding.
• Parental refusal of vitamin K prompted investigation into its prevalence and association with subsequent immunization refusal.

Purpose of the Study:

• To determine the prevalence and characteristics of parents who refuse vitamin K for their infants.
• To assess the association between vitamin K refusal and subsequent refusal of childhood immunizations.

Main Methods:

• Retrospective population-based cohort study using linked administrative health data (Alberta, 2006-2012).
• Poisson regression used to identify risk factors for vitamin K refusal.
• Relative risk assessed the association between vitamin K refusal and non-immunization.

Main Results:

• 0.3% of 282,378 infants declined vitamin K prophylaxis.
• Vitamin K refusal was associated with midwife-assisted delivery, planned home birth, or birth center delivery.
• Vitamin K refusal increased the relative risk of no childhood vaccines at 15 months by 14.6-fold.

Conclusions:

• First population-based study characterizing parents who refuse vitamin K and whose children remain unimmunized.
• Findings allow earlier identification of high-risk parents.
• Opportunities exist to implement strategies for increasing uptake of vitamin K and childhood immunizations.