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Efficacy of oral water soluble vitamin K in neonates
Insights
Oral vitamin K prophylaxis in newborns is as effective as injectable forms. This study found oral administration significantly prevents prolonged prothrombin time in exclusively breastfed infants.
Area of Science:
- Neonatal Medicine
- Pediatric Hematology
- Nutritional Science
Background:
- Vitamin K deficiency bleeding (VKDB) is a risk in exclusively breastfed infants.
- Prothrombin time (PT) is a key indicator of coagulation status.
- Standard prophylaxis often involves intramuscular (IM) vitamin K injections.
Purpose of the Study:
- To evaluate the efficacy of oral water-soluble synthetic vitamin K in preventing prolonged prothrombin time in newborns.
- To compare oral vitamin K with IM vitamin K and no prophylaxis.
Main Methods:
- A randomized controlled trial involving 120 full-term, exclusively breastfed infants.
- Four groups received different vitamin K regimens: 1 mg IM, 0.5 mg IM, 1 mg oral, or no vitamin K.
- Prothrombin time was measured between 36-72 hours of age.
Main Results:
- Infants receiving no vitamin K (Group D) showed significantly prolonged prothrombin times (33.1 +/- 12.2 seconds) compared to other groups (p < 0.001).
- No significant differences in prothrombin time were observed between infants receiving 1 mg IM (Group A), 0.5 mg IM (Group B), or 1 mg oral (Group C) vitamin K.
- Oral vitamin K (Group C) demonstrated comparable efficacy to IM vitamin K (Groups A & B).
Conclusions:
- Oral water-soluble vitamin K at birth is an effective alternative to injectable vitamin K for preventing prolonged prothrombin time in exclusively breastfed infants.
- Oral administration offers a simpler and less invasive method for vitamin K prophylaxis.
- This approach can enhance compliance and reduce the need for intramuscular injections.
Abstract:
Effect of oral water soluble synthetic Vitamin K on prothrombin time was evaluated in 120 full term exclusively breast fed babies. Group A (n = 30) received 1 mg vitamin K (menadione sodium disulphite) intramuscularly at birth, Group B (n = 30) received 0.5 mg intramuscularly, Group C (n = 30) 1 mg orally and Group D (n = 30) did not receive any vitamin K. Prothrombin time (PT) was measured in all between 36-72 hours of age. The PT values in the four Groups A, B, C and D were 17.1 +/- 2.68 seconds, 17.2 +/- 4.42 seconds, 17.0 +/- 2.86 seconds, and 33.1 +/- 12.2 seconds, respectively; the control being 17.0 seconds. The differences between Groups A, B and C were insignificant. Group D babies had a significant prolongation of prothrombin time (p less than 0.001) as compared to the other groups. It is concluded that oral water soluble vitamin K at birth is as good as injectable vitamin K. It is a much simpler form of prophylaxis and avoids intramuscular injection.