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Vitamin K prophylaxis in the neonates by oral route with different dosages
Insights
Oral vitamin K1 prophylaxis is effective in newborns. A 2 mg oral dose is recommended for preventing hemorrhagic disease of the newborn (HDN) and vitamin K deficiency bleeding (VKDB) in breastfed infants.
Area of Science:
- Neonatal Medicine
- Pediatric Pharmacology
- Hematology
Background:
- Hemorrhagic disease of the newborn (HDN) and vitamin K deficiency bleeding (VKDB) are preventable conditions.
- Vitamin K prophylaxis is standard practice for newborns.
- Oral administration of vitamin K1 (VKP) offers potential advantages over parenteral routes.
Purpose of the Study:
- To evaluate the efficacy of different oral doses of vitamin K1 compared to the standard parenteral route in neonates.
- To assess the impact of VKP on vitamin K-dependent clotting factors.
Main Methods:
- A study involving 236 healthy, breastfed infants divided into four groups.
- Groups received either 1 mg of vitamin K1 intramuscularly or 2, 3, or 5 mg orally within 2-4 hours of birth.
- Vitamin K-dependent clotting factors were measured using the thrombotest at 2 weeks and 4-6 weeks of age.
Main Results:
- No statistically significant differences were observed in mean prothrombin complex levels or the number of prothrombin-deficient subjects among the four groups.
- Oral vitamin K1 prophylaxis, particularly a 2 mg dose, demonstrated comparable efficacy to the parenteral route.
Conclusions:
- A 2 mg oral dose of vitamin K1 is a beneficial and practical option for routine prophylaxis in newborns, especially breastfed infants, to prevent HDN and VKDB.
- Oral VKP is recommended due to its ease of administration, low cost, low toxicity, and high efficacy, making it suitable for developing countries.
Abstract:
This paper evaluated the effect of VKP in the neonates by oral route with different dosages compared to the standard parenteral route giving a single dose at birth. Two hundred and thirty-six healthy, breast-fed infants were divided into 4 groups receiving vitamin K1 1 mg intramuscularly and 2, 3, 5 mg orally during 2-4 hours after birth. The vitamin K dependent clotting factors were measured by the thrombotest at the age of 2 weeks and 4-6 weeks. The result showed no statistical differences among these 4 groups regarding the mean prothrombin complex level and the number of PC deficient subjects. Vitamin K prophylaxis in the newborn babies by 2 mg oral route would be benefit and can be applied routinely as well as 1 mg parenteral route to prevent both HDN and APCD syndrome particularly in breast fed infants. The routine practice of giving vitamin K1 prophylaxis 2 mg orally or 0.5-1 mg intramuscularly should be recommended to all newborn infants. Giving VKP by oral route is practical for developing countries because of simple way of administration, low cost, low toxicity, as well as high efficacy.