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Factors Associated With Refusal of Intramuscular Vitamin K in Normal Newborns

Jaspreet Loyal1, James A Taylor2, Carrie A Phillipi3

  • 1Department of Pediatrics, Yale University, New Haven, Connecticut; jaspreet.loyal@yale.edu.

Pediatrics
|July 22, 2018
PubMed

Insights

Parental refusal of intramuscular vitamin K for newborns is a growing concern. Factors like exclusive breastfeeding and non-Hispanic white ethnicity are associated with this refusal, necessitating interventions.

Area of Science:

  • Neonatal care
  • Public health
  • Pediatric medicine

Background:

  • Parental refusal of intramuscular (IM) vitamin K is an increasing issue.
  • This practice poses potential risks to newborns.
  • Understanding refusal patterns is crucial for maternal and child health.

Purpose of the Study:

  • To determine the frequency of IM vitamin K refusal in well newborns in the U.S.
  • To identify factors associated with parental refusal of IM vitamin K administration.

Main Methods:

  • A nested patient-control study was conducted within the Better Outcomes through Research for Newborns network.
  • Multiple logistic regression models were used to identify associated factors.
  • Data analyzed included over 100,000 newborns across 35 sites.

Main Results:

  • The overall refusal rate for IM vitamin K was 0.6% (638/102,878 newborns).
  • Refusal rates varied significantly by site (0% to 2.3%).
  • Associated factors included exclusive breastfeeding, non-Hispanic white race/ethnicity, female infant sex, gestational age, and maternal age. Refusal of other routine newborn medications also correlated strongly.

Conclusions:

  • Parental refusal of IM vitamin K is a significant and documented problem.
  • Targeted interventions are required to mitigate risks for newborns whose parents refuse IM vitamin K.
Abstract

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