Vitamin K supplementation to prevent hemorrhagic morbidity and mortality of newborns in India and China
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Vitamin K supplementation to prevent hemorrhagic morbidity and mortality of newborns in India and China Rajesh Kumar Rai, Jing Luo, Theodore Herzl Tulchinsky Suri, India
Data sources: Studies were integrated from the PubMed/MEDLINE database search, as well as related literature available elsewhere. Results: Both India and China have been slow in adopting an effective program for administering vitamin K injections to newborns to prevent VKDB-related morbidity and mortality. VKDB cases in China and India have shown inadequate attention to routine use of vitamin K by injection. Conclusions: While no reliable data are publicly available, the issue of VKDB is at last receiving some attention from the Chinese public health system as well as the Indian government. In both countries, routine vitamin K administration to newborns would prove to be a costeffective intervention to reduce preventable neonatal morbidity and mortality. VKDB is a global neonatal care issue, including countries where parental resistance is preventing babies from defense against this life-threatening condition. World J Pediatr November 2016; Online First
Author Affiliations: Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, India (Rai RK); Braun School Public Health and Community Medicine, Hebrew University-Hadassah, Ein Karem, Jerusalem, Israel (Luo J, Tulchinsky TH) Corresponding Author: Rajesh Kumar Rai, Senior Research Scientist, Society for Health and Demographic Surveillance, Suri, Birbhum 731101, West Bengal, India (Tel: +91-3462-250371; Email: [email protected]) doi: 10.1007/s12519-016-0062-6 ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2016. All rights reserved.
World J Pediatr, Online First, November 2016 . www.wjpch.com
Key words: global health; hemorrhagic disease of the newborn; intracranial hemorrhage; neonatal mortality; vitamin K deficiency bleeding disorder
V
itamin K deficiency bleeding (VKDB) (previously known as hemorrhagic disease of the newborn or HDN) is of particular concern in neonates as they are born with low levels of vitamin K. The risk of morbidity and mortality from hemorrhage increases among newborns who do not receive vitamin K prophylaxis at birth. VKDB can cause prolonged and excessive bleeding, including intracranial hemorrhage (ICH) which is life-threatening and may even lead to long-term morbidity. Vitamin K deficiency as a cause of HDN has long been a known clinical entity, and its relationship with HDN was discovered by Danish biochemist Henrik Dam in 1939 along with American researcher Edward Doisy, for which they were awarded the 1943 Nobel Prize in physiology or medicine for their discovery of vitamin K and its chemical nature.[1] VKDB can occur as one of three distinct presentations: early, classical or late. Early disease occurs in the first 24 hours of life and is often associated with in utero exposure to anticonvulsant or anticoagulant medications. The bleeding associated with early onset of the disease
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