International Perspectives on Vitamin K Deficiency Bleeding in Infants: A Cross-Sectional Questionnaire-Based Survey

Area of Science:

• Neonatal Medicine
• Pediatric Hematology
• Public Health

Background:

• Vitamin K deficiency bleeding (VKDB) poses a risk to neonates and infants due to low vitamin K transfer and storage.
• Global vitamin K (VK) prophylaxis at birth has reduced VKDB incidence, but it remains a significant concern.

Purpose of the Study:

• To assess the current incidence, risk factors, and outcomes of VKDB.
• To identify barriers and limitations to vitamin K prophylaxis worldwide.

Main Methods:

• A global survey of physicians managing VKDB or VK prophylaxis was conducted from 2021-2023.
• Responses from 685 physicians across 38 countries were analyzed using chi-square tests and hierarchical clustering.

Main Results:

• 42.1% of physicians reported treating 1-5 VKDB cases annually.
• Lack of VK at birth and liver disease were primary risk factors.
• Hierarchical clustering revealed geographical and economic disparities in risk factors and prophylaxis barriers, including parental refusal in high-income countries and limited VK availability in low-income countries.

Conclusions:

• VKDB persists globally despite prophylaxis efforts.
• Specific guidelines for infants with liver disease and enhanced parental education are crucial.
• Addressing global disparities in VK availability is essential for effective VKDB management.