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Am J Public Health. 1998 February; 88(2): 203–209.
PMCID: PMC1508196

Vitamin K prophylaxis in less developed countries: policy issues and relevance to breastfeeding promotion.

Abstract

Vitamin K prophylaxis prevents hemorrhagic disease of the newborn. The present review estimates the potential magnitude of this problem in less developed countries, assessing the need for prophylaxis, along with its cost-effectiveness and feasibility. Late hemorrhagic disease, occurring between 2 and 12 weeks, often leads to death or permanent disability. Its median incidence in developed countries is 7 per 100,000 births. Incidences in less developed countries may be much higher. Three incidence scenarios are proposed and the corresponding losses of disability-adjusted life-years (DALYs) calculated. Under the intermediate scenario, late hemorrhagic disease accounts for 0.1% to 0.2% of DALYs lost to children less than 5 years of age. Assuming a cost of +1.00 per injection, each DALY saved would cost +133. Decisions on prophylaxis must be made on a national basis, considering mortality levels and causes, health budgets, and feasibility. Comparison with the impact of diseases prevented by breast-feeding shows that concern with hemorrhagic disease should not affect breast-feeding promotion efforts, although strategies for supplementing breast-fed infants must be explored.

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  • Lane PA, Hathaway WE. Vitamin K in infancy. J Pediatr. 1985 Mar;106(3):351–359. [PubMed]
  • American Academy of Pediatrics Vitamin K Ad Hoc Task Force: Controversies concerning vitamin K and the newborn. Pediatrics. 1993 May;91(5):1001–1003. [PubMed]
  • von Kries R, Hanawa Y. Neonatal vitamin K prophylaxis. Report of Scientific and Standardization Subcommittee on Perinatal Haemostasis. Thromb Haemost. 1993 Mar 1;69(3):293–295. [PubMed]
  • von Kries R. Vitamin K prophylaxis--a useful public health measure? Paediatr Perinat Epidemiol. 1992 Jan;6(1):7–13. [PubMed]
  • Shearer MJ. Vitamin K. Lancet. 1995 Jan 28;345(8944):229–234. [PubMed]
  • Lovric VA, Jones RF. The haemorrhagic syndrome of early childhood. Australas Ann Med. 1967 May;16(2):173–175. [PubMed]
  • Loughnan PM, McDougall PN. Epidemiology of late onset haemorrhagic disease: a pooled data analysis. J Paediatr Child Health. 1993 Jun;29(3):177–181. [PubMed]
  • Hanawa Y, Maki M, Murata B, Matsuyama E, Yamamoto Y, Nagao T, Yamada K, Ikeda I, Terao T, Mikami S, et al. The second nation-wide survey in Japan of vitamin K deficiency in infancy. Eur J Pediatr. 1988 Jun;147(5):472–477. [PubMed]
  • Hanawa Y, Maki M, Matsuyama E, Tada H, Urayama T, Yamada K, Mori H, Nagao T, Terao T, Mikami S, et al. The third nationwide survey in Japan of vitamin K deficiency in infancy. Acta Paediatr Jpn. 1990 Feb;32(1):51–59. [PubMed]
  • McNinch AW, Tripp JH. Haemorrhagic disease of the newborn in the British Isles: two year prospective study. BMJ. 1991 Nov 2;303(6810):1105–1109. [PMC free article] [PubMed]
  • von Kries R, Göbel U. Vitamin K prophylaxis and vitamin K deficiency bleeding (VKDB) in early infancy. Acta Paediatr. 1992 Sep;81(9):655–657. [PubMed]
  • Ungchusak K, Tishyadhigama S, Choprapawon C, Sawadiwutipong W, Varintarawat S. Incidence of idiopathic vitamin K deficiency in infants: a national, hospital based, survey in Thailand, 1983. J Med Assoc Thai. 1988 Aug;71(8):417–421. [PubMed]
  • Laosombat V, Kenpitak K, Wongchanchailert M, Wiriyasateinkul A. Acarboxy prothrombin (PIVKA-II) in cord plasma in the south of Thailand. J Med Assoc Thai. 1993 May;76(5):278–284. [PubMed]
  • Merchant RH, Divekar RM. Late hemorrhagic disease with intracranial hemorrhage. Indian Pediatr. 1988 Apr;25(4):381–384. [PubMed]
  • Marwaha RK, Kumar A, Garewal G, Marwaha N, Walia BN. Vitamin K deficiency related bleeding manifestations in older neonates and infants. Indian Pediatr. 1987 Apr;24(4):307–311. [PubMed]
  • Merchant RH, Divekar R, Shah MD. Late hemorrhagic disease of infancy. Indian Pediatr. 1989 Jun;26(6):553–557. [PubMed]
  • Bhanchet-Isarangkura P. The pathogenesis of acquired prothrombin complex deficiency syndrome (APCD syndrome) in infants. Southeast Asian J Trop Med Public Health. 1979 Sep;10(3):350–352. [PubMed]
  • Chan MC, Boon WH. Late haemorrhagic disease of Singapore infants. J Singapore Paediatr Soc. 1967 Oct;9(2):72–81. [PubMed]
  • Chaou WT, Chou ML, Eitzman DV. Intracranial hemorrhage and vitamin K deficiency in early infancy. J Pediatr. 1984 Dec;105(6):880–884. [PubMed]
  • Sutherland JM, Glueck HI, Gleser G. Hemorrhagic disease of the newborn. Breast feeding as a necessary factor in the pathogenesis. Am J Dis Child. 1967 May;113(5):524–533. [PubMed]
  • McNinch AW, Orme RL, Tripp JH. Haemorrhagic disease of the newborn returns. Lancet. 1983 May 14;1(8333):1089–1090. [PubMed]
  • Nagao T, Nakayama K. Vitamin K deficiency in infancy in Japan. Pediatrics. 1984 Aug;74(2):315–316. [PubMed]
  • Behrmann BA, Chan WK, Finer NN. Resurgence of hemorrhagic disease of the newborn: a report of three cases. CMAJ. 1985 Nov 1;133(9):884–885. [PMC free article] [PubMed]
  • von Kries R, Göbel U. Oral vitamin K prophylaxis and late haemorrhagic disease of the newborn. Lancet. 1994 Feb 5;343(8893):352–352. [PubMed]
  • Barton JS, McNinch AW, Tripp JH. Oral vitamin K prophylaxis and frequency of late vitamin K deficiency bleeding. Lancet. 1994 May 7;343(8906):1168–1168. [PubMed]
  • Gat U, Nekrasova E, Lancet D, Natochin M. Olfactory receptor proteins. Expression, characterization and partial purification. Eur J Biochem. 1994 Nov 1;225(3):1157–1168. [PubMed]
  • Soin H, Katesmark M. Midwifery. By mouth or muscle? Nurs Times. 1993 Oct 20;89(42):32–33. [PubMed]
  • Tönz O, Schubiger G. Neonatale Vitamin-K-Prophylaxe und Vitamin-K-Mangelblutungen in der Schweiz 1986-1988. Schweiz Med Wochenschr. 1988 Nov 26;118(47):1747–1752. [PubMed]
  • Joubert PH, Stoeckel K. Oral vitamin K in breast-fed infants to prevent late haemorrhagic disease of the newborn. Lancet. 1994 Aug 13;344(8920):484–485. [PubMed]
  • Schubiger G, Tönz O, Grüter J, Shearer MJ. Vitamin K1 concentration in breast-fed neonates after oral or intramuscular administration of a single dose of a new mixed-micellar preparation of phylloquinone. J Pediatr Gastroenterol Nutr. 1993 May;16(4):435–439. [PubMed]
  • Clarkson PM, James AG. Parenteral vitamin K1: the effective prophylaxis against haemorrhagic disease for all newborn infants. N Z Med J. 1990 Mar 14;103(885):95–96. [PubMed]
  • Haroon Y, Shearer MJ, Rahim S, Gunn WG, McEnery G, Barkhan P. The content of phylloquinone (vitamin K1) in human milk, cows' milk and infant formula foods determined by high-performance liquid chromatography. J Nutr. 1982 Jun;112(6):1105–1117. [PubMed]
  • Saga K, Terao T. [Studies on transfer of vitamin K into human breast milk]. Nihon Sanka Fujinka Gakkai Zasshi. 1989 Nov;41(11):1713–1719. [PubMed]
  • Shimada H, Himeno K, Michimoto T, Tanada S, Ikeuchi M, Suwa M, Ono Y, Hoshino T, Takashima E, Ohkura K, et al. [Prevention of vitamin K deficiency in the early neonatal period--prophylactic oral administration of VK to the mother]. Nihon Sanka Fujinka Gakkai Zasshi. 1990 Jul;42(7):705–710. [PubMed]
  • Golding J, Paterson M, Kinlen LJ. Factors associated with childhood cancer in a national cohort study. Br J Cancer. 1990 Aug;62(2):304–308. [PMC free article] [PubMed]
  • Golding J, Greenwood R, Birmingham K, Mott M. Childhood cancer, intramuscular vitamin K, and pethidine given during labour. BMJ. 1992 Aug 8;305(6849):341–346. [PMC free article] [PubMed]
  • Draper GJ, Stiller CA. Intramuscular vitamin K and childhood cancer. BMJ. 1992 Sep 19;305(6855):709–711. [PMC free article] [PubMed]
  • Olsen JH, Hertz H, Blinkenberg K, Verder H. Vitamin K regimens and incidence of childhood cancer in Denmark. BMJ. 1994 Apr 2;308(6933):895–896. [PMC free article] [PubMed]
  • Miller RW. Vitamin K and childhood cancer. BMJ. 1992 Oct 24;305(6860):1016–1016. [PMC free article] [PubMed]
  • Klebanoff MA, Read JS, Mills JL, Shiono PH. The risk of childhood cancer after neonatal exposure to vitamin K. N Engl J Med. 1993 Sep 23;329(13):905–908. [PubMed]
  • Ekelund H, Finnström O, Gunnarskog J, Källén B, Larsson Y. Administration of vitamin K to newborn infants and childhood cancer. BMJ. 1993 Jul 10;307(6896):89–91. [PMC free article] [PubMed]
  • Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AM, Fuchs SM, Moreira LB, Gigante LP, Barros FC. Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil. Lancet. 1987 Aug 8;2(8554):319–322. [PubMed]

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