Increasing the dose of oral vitamin K prophylaxis and its effect on bleeding risk

Yvette Nicole Lowensteyn, Nicolaas Johannes Georgius Jansen, Marc van Heerde, Richard Henryk Klein, Martin Christiaan Jacques Kneyber, Jan Willem Kuiper, Maaike Anne Riedijk, Carin Wilhelmus Maria Verlaat, Idse Hendrik Egbert Visser, Dirk Adriaan van Waardenburg, Peter Marin van Hasselt*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Vitamin K prophylaxis in infancy aims to prevent life-threatening vitamin K deficiency bleeding (VKDB). The Dutch prophylactic oral daily regimen was increased sixfold from 25 to 150g because of a high failure rate. To evaluate the efficacy of this new regimen, incidences of intracranial VKDB under both regimens were compared using both general and targeted surveillance. Late VKDB in the general pediatric population was identified by the Netherlands Pediatric Surveillance Unit, between 1 October 2014 and 31 December 2016. Additionally, infants with intracranial vitamin K deficiency bleeding were identified using the Dutch Pediatric Intensive Care Evaluation registry. The incidence of intracranial VKDB as assessed by general and targeted surveillance decreased from 1.6 per 100,000 (95% CI, 0.4-5.1) to 1.3 per 100,000 (95% CI, 0.5-3.2) and from 3.1 per 100,000 live births (95% CI, 1.9-5.0) to 1.2 per 100,000 live births (95% CI, 0.6-2.3), respectively. Median time between consecutive cases in the latter increased from 24 to 154days (p

Original languageEnglish
Pages (from-to)1033-1042
Number of pages10
JournalEuropean Journal of Pediatrics
Issue number7
Publication statusPublished - Jul 2019


  • Biliary atresia
  • Intracranial bleeding
  • Pediatric intensive care unit
  • Vitamin K prophylaxis
  • Vitamin K deficiency bleeding
  • VKDB


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