Factors associated with refusal of intramuscular Vitamin K in normal newborns

Jaspreet Loyal, James A. Taylor, Carrie Phillipi, Neera K. Goyal, Kelly E. Wood, Carl Seashore, Beth King, Eve Colson, Veronika Shabanova, Eugene D. Shapiro

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVE: Refusal of intramuscular (IM) Vitamin K administration by parents is an emerging problem. Our objective was to assess the frequency of and factors associated with refusal of IM Vitamin K administration in well newborns in the United States. METHODS: We determined the number of newborns admitted to well newborn units whose parents refused IM Vitamin K administration in the Better Outcomes through Research for Newborns network and, in a nested patient-control study, identified factors associated with refusal of IM Vitamin K administration by using a multiple logistic regression model. RESULTS: Of 102878 newborns from 35 Better Outcomes through Research for Newborns sites, parents of 638 (0.6%) refused IM Vitamin K administration. Frequency of refusal at individual sites varied from 0% to 2.3%. Exclusive breastfeeding (adjusted odds ratio [aOR] = 3.4; 95% confidence interval [CI]: 2.1–5.5), non-Hispanic white race and/or ethnicity (aOR = 1.7; 95% CI: 1.2–2.4), female sex (aOR = 1.6; 95% CI: 1.2–2.3), gestational age (aOR = 1.2; 95% CI: 1.1–1.4), and mother’s age (aOR = 1.05; 95% CI: 1.02–1.08) were significantly associated with refusal of IM Vitamin K administration. Refusal of the administration of both ocular prophylaxis and hepatitis B vaccine was also strongly associated with refusal of IM Vitamin K administration (aOR = 88.7; 95% CI: 50.4–151.9). CONCLUSIONS: Refusal of IM Vitamin K by parents of newborns is a significant problem. Interventions to minimize risks to these newborns are needed.

Original languageEnglish (US)
Article numbere20173743
JournalPediatrics
Volume142
Issue number2
DOIs
StatePublished - Aug 1 2018

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Vitamin K
Newborn Infant
Odds Ratio
Confidence Intervals
Parents
Ophthalmic Administration
Logistic Models
Outcome Assessment (Health Care)
Hepatitis B Vaccines
Breast Feeding
Gestational Age
Mothers

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Loyal, J., Taylor, J. A., Phillipi, C., Goyal, N. K., Wood, K. E., Seashore, C., ... Shapiro, E. D. (2018). Factors associated with refusal of intramuscular Vitamin K in normal newborns. Pediatrics, 142(2), [e20173743]. https://doi.org/10.1542/peds.2017-3743

Factors associated with refusal of intramuscular Vitamin K in normal newborns. / Loyal, Jaspreet; Taylor, James A.; Phillipi, Carrie; Goyal, Neera K.; Wood, Kelly E.; Seashore, Carl; King, Beth; Colson, Eve; Shabanova, Veronika; Shapiro, Eugene D.

In: Pediatrics, Vol. 142, No. 2, e20173743, 01.08.2018.

Research output: Contribution to journalArticle

Loyal, J, Taylor, JA, Phillipi, C, Goyal, NK, Wood, KE, Seashore, C, King, B, Colson, E, Shabanova, V & Shapiro, ED 2018, 'Factors associated with refusal of intramuscular Vitamin K in normal newborns', Pediatrics, vol. 142, no. 2, e20173743. https://doi.org/10.1542/peds.2017-3743
Loyal, Jaspreet ; Taylor, James A. ; Phillipi, Carrie ; Goyal, Neera K. ; Wood, Kelly E. ; Seashore, Carl ; King, Beth ; Colson, Eve ; Shabanova, Veronika ; Shapiro, Eugene D. / Factors associated with refusal of intramuscular Vitamin K in normal newborns. In: Pediatrics. 2018 ; Vol. 142, No. 2.
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abstract = "BACKGROUND AND OBJECTIVE: Refusal of intramuscular (IM) Vitamin K administration by parents is an emerging problem. Our objective was to assess the frequency of and factors associated with refusal of IM Vitamin K administration in well newborns in the United States. METHODS: We determined the number of newborns admitted to well newborn units whose parents refused IM Vitamin K administration in the Better Outcomes through Research for Newborns network and, in a nested patient-control study, identified factors associated with refusal of IM Vitamin K administration by using a multiple logistic regression model. RESULTS: Of 102878 newborns from 35 Better Outcomes through Research for Newborns sites, parents of 638 (0.6{\%}) refused IM Vitamin K administration. Frequency of refusal at individual sites varied from 0{\%} to 2.3{\%}. Exclusive breastfeeding (adjusted odds ratio [aOR] = 3.4; 95{\%} confidence interval [CI]: 2.1–5.5), non-Hispanic white race and/or ethnicity (aOR = 1.7; 95{\%} CI: 1.2–2.4), female sex (aOR = 1.6; 95{\%} CI: 1.2–2.3), gestational age (aOR = 1.2; 95{\%} CI: 1.1–1.4), and mother’s age (aOR = 1.05; 95{\%} CI: 1.02–1.08) were significantly associated with refusal of IM Vitamin K administration. Refusal of the administration of both ocular prophylaxis and hepatitis B vaccine was also strongly associated with refusal of IM Vitamin K administration (aOR = 88.7; 95{\%} CI: 50.4–151.9). CONCLUSIONS: Refusal of IM Vitamin K by parents of newborns is a significant problem. Interventions to minimize risks to these newborns are needed.",
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