engleski

Prophylactic use of vitamin K for newborns in Croatia-public health issue

Background and purpose: Administration of vitamin K at birth has long been considered the medical standard of practice to prevent vitamin K deficiency bleeding (VKDB), and has been widely implemented in many countries. Material and methods: The Vitamin K1 situation in Croatia was checked by phone interview with all 37 maternity wards in Croatia. The mortality data from the Central bureau of statistics and morbidity data from the National Institute of Public Health for the last five years period 1997-2001 were reviewed. The review included only primary cause of death (or morbidity) with code P53 (hemorrhagic disease of the newborn) according to the 10th Revision of the International Classification of Disease. Results: Lack of uniform policy for vitamin K1 administration in Croatia results in variations regarding administration itself, dosage and route. The majority of maternity wards, 97.6%, use it nonselective but one of maternity ward which doesn’ t use it nonselective has more than 10% of newborns. The influence of vitamin K deficency to infant mortality and morbidity is not easy to evaluate because on the hospital records and death records only main cause of morbidity and mortality is mentioned. In the last five years period, from 1997 to 2001, because of hemorrhagic disease (code P53) as the main cause of death died 4 infants (1997 none ; 1998 two ; 1999 none, 2000 one, 2001 one). But among main causes of death data shows that 10% of infants died because of intracranial nontraumatic bleeding (code P52) which could be connected with immaturity and short gestational age. Conclusion: The newborn care should be reconsidered and priority given to painless and harmless practices based on good scientific evidence. In that sense we would recommend administration of vitamin K orally in the all maternity wards in Croatia according to the uniform schedule.

vitamin K ; vitamin K deficiency bleeding ; public health ; Croatia

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