Prophylactic Vitamin K for Vitamin K Deficiency Bleeding in Neonates

Summary

A Cochrane review 02776[Abstract] 1 included 2 studies comparing a single dose of intramuscular vitamin K with placebo or nothing. Vitamin K deficiency can cause bleeding in an infant in the first weeks of life. One dose of vitamin K (1.0 mg) reduced clinical bleeding at 1-7 days (RR 0.73, 95% CI 0.56 to 0.96; 1 trial, n=3338) and improved biochemical indices of coagulation status. A single oral compared with a single intramuscular dose resulted in lower plasma vitamin K levels at two weeks and one month (RR -0.23, 95% CI (-0.30 to -0.16; 2 trials, n=200).

A Systematic review evaluated the burden of late vitamin K deficiency bleeding (VKDB) and the effect of vitamin K prophylaxis on the incidence of VKDB.The burden was much higher in low- and middle-income countries as compared with high-income countries (80 vs 8.8 per 100 000 live births in infants who had not received prophylaxis at birth). Two RCT evaluated the effect of intramuscular prophylaxis on the risk of classical VKDB.