Journal
ACTA PAEDIATRICA
Volume 110, Issue 11, Pages 2937-2943Publisher
WILEY
DOI: 10.1111/apa.16011
Keywords
Intracranial Haemorrhage; Vitamin K deficiency; Vitamin K deficiency bleeding
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This review highlights the association of intracranial hemorrhage in infancy with potentially preventable vitamin K deficiency, with late-onset vitamin K deficiency being the main risk factor. Prophylactic measures such as administering vitamin K to mothers or supplementing exclusively breastfed infants with vitamin K may have an impact on prevention and outcome.
Aim Intracranial haemorrhage (ICH) in infancy is a rare life-threatening event. The aim of this review is to highlight the association of ICH and potentially preventable vitamin K deficiency and to describe risk factors, presentation and outcome. Methods Original published data on ICH related to vitamin K deficiency during 2008-2012 were extracted from records of participating centres in Egypt (Cairo and Delta region). Full data on 70 infants (0-24 weeks) have been reported in three publications. Results The first study involved premature infants where ICH was potentially preventable with administration of parenteral vitamin K prophylactic doses to mothers ahead of imminent preterm delivery. The other 2 studies involved term newborns and infants. ICH due to early or classic vitamin K deficiency was reported in nine patients while 44 were due to late vitamin K deficiency. Main risk factors for late onset were exclusive breastfeeding, persistent diarrhoea and/or prolonged antibiotic therapy. Conclusion Vitamin K deficiency bleeding is a relatively frequent problem underlying ICH in infancy. Prophylactic vitamin K to mothers when anticipating preterm labour or a vitamin K boost in exclusively breast-fed infants with prolonged antibiotic usage and, or, persistent diarrhoea might have an impact on prevention and outcome.
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