title: Late haemorrhagic disease of the newborn.
abstract: BACKGROUND
  Late haemorrhagic disease of the newborn (HDN) can occur owing to a lack of vitamin K prophylaxis, as a manifestation of an underlying disorder or idiopatically from the 8th day to 12 weeks after birth.
  
  
  METHODS
  Eight infants admitted to Kocaeli University Hospital with nine episodes of late HDN between January 2002 and April 2005 were evaluated retrospectively from hospital records.
  
  
  RESULTS
  The median age at presentation was 46 (26-111) days. All the infants were born at full-term to healthy mothers and were exclusively breast-fed. All had an uneventful perinatal history, except one who had meconium aspiration. Four patients had received no vitamin K prophylaxis and another three had uncertain histories. At presentation, six had intracranial bleeding and the remainder had bleeding either from the venepuncture site or the gastro-intestinal tract. The presenting signs and symptoms were irritability, vomiting, bulging or full fontanelle, convulsions and diminished or absent neonatal reflexes. Galactosaemia was detected in a 2-month-old infant with prolonged jaundice. There was no surgery-related mortality or complications but one survived for only 2 days on ventilatory support following surgery. Only one of the six survivors had severe neurological sequelae.
  
  
  CONCLUSIONS
  Late HDN frequently presents with intracranial haemorrhage, leading to high morbidity and mortality. HDN can be the manifestation of an underlying metabolic disorder. Vitamin K prophylaxis of the newborn should be routine in developing countries.
authors.affiliation: Department of Paediatrics, Faculty of Medicine, University of Kocaeli, Turkey. eminezengin@yahoo.com
authors.forename: Emine
authors.initials: E
authors.lastname: Zengin
authors.forename: Nazan
authors.initials: N
authors.lastname: Sarper
authors.forename: Gülcan
authors.initials: G
authors.lastname: Türker
authors.forename: Funda
authors.initials: F
authors.lastname: Corapçioğlu
authors.forename: Volkan
authors.initials: V
authors.lastname: Etuş
mesh_terms: D000367:Age Factors; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000601:surgery; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014812:Vitamin K / Q000627:therapeutic use; D006475:Vitamin K Deficiency Bleeding / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control / Q000601:surgery
chemical_list: D014812:Vitamin K