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. 2018 Aug;142(2):e20173743.
doi: 10.1542/peds.2017-3743.

Factors Associated With Refusal of Intramuscular Vitamin K in Normal Newborns

Jaspreet Loyal  1 , James A Taylor  2 , Carrie A Phillipi  3 , Neera K Goyal  4 , Kelly E Wood  5 , Carl Seashore  6 , Beth King  7 , Eve Colson  8 , Veronika Shabanova  8 , Eugene D Shapiro  8 ; BORN investigators
Affiliations

Factors Associated With Refusal of Intramuscular Vitamin K in Normal Newborns

Jaspreet Loyal et al. Pediatrics. 2018 Aug.

Abstract

Background and objective: Refusal of intramuscular (IM) vitamin K administration by parents is an emerging problem. Our objective was to assess the frequency of and factors associated with refusal of IM vitamin K administration in well newborns in the United States.

Methods: We determined the number of newborns admitted to well newborn units whose parents refused IM vitamin K administration in the Better Outcomes through Research for Newborns network and, in a nested patient-control study, identified factors associated with refusal of IM vitamin K administration by using a multiple logistic regression model.

Results: Of 102 878 newborns from 35 Better Outcomes through Research for Newborns sites, parents of 638 (0.6%) refused IM vitamin K administration. Frequency of refusal at individual sites varied from 0% to 2.3%. Exclusive breastfeeding (adjusted odds ratio [aOR] = 3.4; 95% confidence interval [CI]: 2.1-5.5), non-Hispanic white race and/or ethnicity (aOR = 1.7; 95% CI: 1.2-2.4), female sex (aOR = 1.6; 95% CI: 1.2-2.3), gestational age (aOR = 1.2; 95% CI: 1.1-1.4), and mother's age (aOR = 1.05; 95% CI: 1.02-1.08) were significantly associated with refusal of IM vitamin K administration. Refusal of the administration of both ocular prophylaxis and hepatitis B vaccine was also strongly associated with refusal of IM vitamin K administration (aOR = 88.7; 95% CI: 50.4-151.9).

Conclusions: Refusal of IM vitamin K by parents of newborns is a significant problem. Interventions to minimize risks to these newborns are needed.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

References

    1. American Academy of Pediatrics Committee on Fetus and Newborn Controversies concerning vitamin K and the newborn. American Academy of Pediatrics Committee on Fetus and Newborn. Pediatrics. 2003;112(1 pt 1):191–192 - PubMed
    1. Pichler E, Pichler L. The neonatal coagulation system and the vitamin K deficiency bleeding - a mini review. Wien Med Wochenschr. 2008;158(13–14):385–395 - PubMed
    1. Sankar MJ, Chandrasekaran A, Kumar P, Thukral A, Agarwal R, Paul VK. Vitamin K prophylaxis for prevention of vitamin K deficiency bleeding: a systematic review. J Perinatol. 2016;36(suppl 1):S29–S35 - PMC - PubMed
    1. Centers for Disease Control and Prevention Notes from the field: late vitamin K deficiency bleeding in infants whose parents declined vitamin K prophylaxis–Tennessee, 2013. MMWR Morb Mortal Wkly Rep. 2013;62(45):901–902 - PMC - PubMed
    1. Abrams S, Savelli SL. Be prepared to address parents’ concerns about vitamin K injection. AAP News. 2014;35(5):1

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