TITLE

Neonatal vitamin K prophylaxis in Great Britain and Ireland: the impact of perceived risk and product licensing on effectiveness

AUTHOR(S)
Busfield, Alison; McNinch, Andrew; Tripp, John
PUB. DATE
September 2007
SOURCE
Archives of Disease in Childhood;Sep2007, Vol. 92 Issue 9, p754
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: To determine current use of vitamin K (VK) prophylaxis in newborns and review the efficacy and effectiveness of regimens used. Design: Efficacy and effectiveness calculated using current practice details, data from Southern Ireland and two previous surveys, together with contemporaneous studies of vitamin K deficiency bleeding (VKDB). Setting: Current survey: United Kingdom (Great Britain and Northern Ireland). Efficacy and effectiveness tables: United Kingdom and Southern Ireland. Main outcome measures: Current VK prophylaxis following uncomplicated term deliveries. Relative risk of VKDB calculated for the VK actually received and for ‘intention to treat’. Results: Questionnaire response rate 95% (n = 243), all recommending VK prophylaxis. No association between unit size and route of administration. For uncomplicated term deliveries, 60% recommended intramuscular (IM) prophylaxis, 24% oral and 16% offered both routes without bias. All units offering IM gave a single dose, mostly 1 mg Konakion Neonatal. Oral regimens showed more variation: two thirds gave 2 mg (range 0.5–2 mg), the number of doses ranged from 1 to 11 and many used preparations off-licence or the unlicensed Orakay. IM prophylaxis, if given, provided the best protection (most efficacious) against VKDB. However, on an intention-to-treat basis (effectiveness), there is no statistically significant difference between the risks of VKDB after intended IM VK and after oral prophylaxis intended to continue beyond a week. Conclusions: Although the principles of VK prophylaxis is now accepted by all, there is no uniformity in practice. Omission of prophylaxis appears to be a greater problem for IM than for multi-dose oral prophylaxis, affecting overall effectiveness.
ACCESSION #
26522954

 

Related Articles

  • Autoimmune Protein S Deficiency in a Boy with Severe Thromboembolic Disease. D'Angelo, Armando; Valle, Patrizia Della; Crippa, Luciano; Pattarini, Elisabetta; Grimaldi, Luigi; D'Angelo, Silvana Vigano // New England Journal of Medicine;6/17/93, Vol. 328 Issue 24, p1753 

    The article presents information on severe thromboembolic disease in a 11-year-old boy with a transient isolated deficiency of protein S. It informs that there was a painful enlargement of the boy's left testicle that occurred during his recovery from chickenpox. At surgery, there was extensive...

  • Vitamin K for neonates: the controversy. Draper, Gerald; McNinch, Andrew // BMJ: British Medical Journal (International Edition);4/2/94, Vol. 308 Issue 6933, p867 

    Analyzes the giving of vitamin K for neonates to prevent vitamin K deficiency bleeding. Description of newborn babies with vitamin K deficiency; Reason of bottle fed babies for not suffering to the vitamin K deficiency; Association of intramuscular vitamin K with a doubling of risk of malignant...

  • Graduated Compression Stocking Thromboprophylaxis for Elderly Inpatients. Labarere, Jose; Bosson, Jean-Luc; Sevestre, Marie-Antoinette; Delmas, Anne-Sophie; Dupas, Stéphane; Thenault, Marie-Hélène; Legagneux, Annie; Boge, Gudrun; Terriat, Béatrice; Pernod, Gilles // JGIM: Journal of General Internal Medicine;Dec2006, Vol. 21 Issue 12, p1282 

    BACKGROUND: Graduated compression stockings (GCS) are often used for deep vein thrombosis prophylaxis in nonsurgical patients, although evidence on their effectiveness is lacking in this setting. OBJECTIVE: To determine whether prophylaxis with GCS is associated with a decrease in the rate of...

  • Nutrition of preterm infants in relation to bronchopulmonary dysplasia. Wemhöner, Andreas; Ortner, Daniel; Tschirch, Edda; Strasak, Alexander; Rüdiger, Mario // BMC Pulmonary Medicine;2011, Vol. 11 Issue 1, p7 

    Background: The pathogenesis of bronchopulmonary dysplasia (BPD) is multifactorial. In addition to prenatal inflammation, postnatal malnutrition also affects lung development. Methods: A retrospective study was performed to analyse during the first two weeks of life the total, enteral and...

  • Severe Respiratory Distress. Naim, Maryam Y.; Smith, Ryan; Schears, Gregory // Clinical Pediatrics;May2004, Vol. 43 Issue 4, p403 

    Reports on the case of a one-month-old infant with a one-week history of poor feeding and vomiting presented with severe respiratory distress. Absence of bowel movements; Poor perfusion and mottling; Pyloric stenosis; Abdominal surgery.

  • Enteral Administration of a Simulated Amniotic Fluid to Very Low Birth Weight Neonates. Christensen, Robert D.; Havranek, Thomas; Gerstmann, Dale R.; Calhoun, Darlene A. // Journal of Perinatology;Jun2005, Vol. 25 Issue 6, p380 

    OBJECTIVE:To reduce feeding intolerance among very low birth weight neonates.STUDY DESIGN:A total of 10 neonates with birth weights of 750 to 1250?g were given oral-gastric boluses (2.5?ml/kg every 3 hours) of a solution patterned after amniotic fluid. When milk feedings were begun the milk was...

  • Nutritional state and herniorrhaphy in premature infants. Barreto, Maria Weber Guimarães; Melo-Filho, Antonio Aldo; Neto, Jaime Oliveira; Zeller, Carlos Borelli; Marba, Sérgio; Sbragia, Lourenço // Pediatric Surgery International;Oct2004, Vol. 20 Issue 9, p699 

    The incidence of inguinal hernia in premature infants is significantly high, and the optimal timing for its correction is controversial. Furthermore, whether the nutritional status of neonates will alter hernia diagnosis and postoperative results has not been demonstrated. The aim of this study...

  • Could lipid infusion be a risk for parenteral nutrition-associated cholestasis in low birth weight neonates? Jae Il Shin; Ran Namgung; Min Soo Park; Chul Lee // European Journal of Pediatrics;Feb2008, Vol. 167 Issue 2, p197 

    To assess whether lipid infusion could be a risk factor for parenteral nutrition-associated cholestasis (PNAC) in low birth weight neonates, 22 newborns with cholestasis (29.8 ± 1.6 weeks, 1298 ± 217 g) were compared with 22 without cholestasis (29.5 ± 1.7 weeks, 1286 ± 363 g). The...

  • PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA IN NEONATES. Shaw, Chandan Kumar // International Journal of Pharma & Bio Sciences;Apr-Jun2012, Vol. 3 Issue 2, pP.140 

    Supraventricular tachycardia (SVT) is an uncommon event in the NICU. It may result from underlying cardiac malformation, Wolf- Parkinson-White syndrome, arrhythmogenic drugs or idiopathic in nature. They may or may not result in hemodynamic compromise, nevertheless, need to be treated...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics