VITAMIN 'K' DEFICIENCY HAEMORRHAGIC DISEASE OF NEW-BORN AND PRESENT CONTROVERSIES

Area of Science:

• Pediatrics
• Hematology
• Neonatology

Background:

• Vitamin K deficiency haemorrhagic disease of the newborn (HDN) is a significant cause of bleeding in infants.
• It results from a deficiency in vitamin K-dependent clotting factors (II, VII, IX, X).
• HDN presents in early, classical, and late forms, posing diagnostic and therapeutic challenges.

Purpose of the Study:

• To review the clinical presentations, diagnosis, and management of vitamin K deficiency haemorrhagic disease of the newborn.
• To emphasize the importance of universal vitamin K prophylaxis in neonates.
• To discuss optimal routes and timing of vitamin K administration.

Main Methods:

• Review of existing literature on vitamin K deficiency haemorrhagic disease of the newborn.
• Analysis of diagnostic markers such as Protein Induced in Vitamin K Absence (PIVKA).
• Evaluation of treatment efficacy and safety of different vitamin K administration routes.

Main Results:

• Vitamin K deficiency leads to coagulopathy due to reduced synthesis of specific clotting factors.
• PIVKA levels are elevated in vitamin K deficiency and aid in diagnosis.
• Bleeding symptoms are rapidly reversed with vitamin K administration.
• Intramuscular vitamin K prophylaxis is safe and effective, with no increased risk of childhood cancer.

Conclusions:

• Universal vitamin K prophylaxis is essential for all newborns to prevent HDN.
• Both oral and parenteral routes are effective, though oral administration may require higher doses.
• Breastfed infants with malabsorption or diarrhea may need additional vitamin K doses post-neonatally.