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

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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.

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

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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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