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Matern Child Health J. 2017 May;21(5):1079-1084. doi: 10.1007/s10995-016-2205-8.

Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance.

Author information

1
Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, GA, USA. lauren.marcewicz@gmail.com.
2
Centers for Disease Control and Prevention, Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA. lauren.marcewicz@gmail.com.
3
Department of Veteran's Affairs, Atlanta VA Medical Center, Palliative and Supportive Care, 149 Ridley Lane, Decatur, GA, 30030, USA. lauren.marcewicz@gmail.com.
4
Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, GA, USA.
5
Tennessee Department of Health, Nashville, TN, USA.
6
Centers for Disease Control and Prevention, Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA.
7
Centers for Disease Control and Prevention, Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA.
8
Vanderbilt University School of Medicine, Nashville, TN, USA.

Abstract

Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011-2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation.

KEYWORDS:

Vaccine hesitancy; Vitamin K; Vitamin K deficiency bleeding; Vitamin K prophylaxis

PMID:
28054156
PMCID:
PMC5526450
DOI:
10.1007/s10995-016-2205-8
[Indexed for MEDLINE]
Free PMC Article

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