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Physicians' Opinion and Practice of Vitamin K Administration at Birth in Romania
Andreea Avasiloaiei1, Demetra Gabriela Socolov1, Maria Stamatin1
1Mother and Child Health Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Insights
Parental refusals for vitamin K prophylaxis are common in Romania, often linked to other interventions. Neonatologists suggest addressing parental concerns and exploring alternative vitamin K administration methods.
Area of Science:
- Neonatology
- Pediatric Medicine
- Public Health
Background:
- Vitamin K prophylaxis is a global standard for preventing vitamin-K-deficiency bleeding (VKDB).
- Romanian neonatologists face increasing parental refusals for essential neonatal interventions, including vitamin K.
- This trend impacts standard VKDB prevention protocols.
Purpose of the Study:
- To evaluate Romanian neonatologists' perspectives on vitamin K administration.
- To understand current practices and challenges related to parental refusals for vitamin K at birth.
- To identify potential strategies for improving vitamin K prophylaxis adherence.
Main Methods:
- An electronic survey was distributed to 110 physicians in Romanian hospitals.
- The survey assessed experiences with parental refusals for vitamin K and related interventions.
- Statistical analysis was performed to identify trends and significant factors.
Main Results:
- Approximately 50% of neonatologists report parental refusals for vitamin K once or twice annually.
- Over 90% of physicians note that parents refusing vitamin K also refuse other neonatal interventions.
- Refusals and their increase are more prevalent in level III hospitals.
- Only 22.7% of respondents would recommend oral vitamin K if intramuscular prophylaxis were unavailable.
Conclusions:
- Addressing parental concerns regarding vitamin K administration is crucial.
- Developing and offering alternatives to intramuscular vitamin K is recommended.
- Further research into parental hesitancy and effective communication strategies is warranted.
Abstract:
(1) Background. Vitamin K is recommended worldwide as a standard of care for the prophylaxis of vitamin-K-deficiency bleeding (VKDB). This is also a standard practice in Romania, but due to the rising number of refusals by parents of basic interventions in the neonatal period, we aimed to assess the Romanian neonatologists' opinions and current practice regarding vitamin K administration at birth. (2) Methods. We designed and conducted an electronic survey addressed to 110 physicians working in Romanian hospitals. (3) Results. Half of respondents are accustomed to receiving refusals for vitamin K administration once or twice a year. When parents refuse vitamin K administration, they usually refuse other neonatal interventions, according to 90.9% of the responding physicians, and this situation has occurred more frequently during the last two years. The number of refusals and especially their increase are more frequent in level III hospitals (p = 0.0304, p = 0.0036, respectively). Only 22.7% of the physicians responded that they would recommend an oral preparation of vitamin K in the absence of intramuscular prophylaxis. (4) Conclusion. Efforts should be made to address parents' concerns and to have available alternatives to the intramuscular administration of vitamin K.
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