title: A survey of the management of newborns with severe hemophilia in Canada.
abstract: OBJECTIVE
  To determine the practice patterns of Canadian hematologists and neonatologists/paediatricians who care for newborns with hemophilia, with regard to vitamin K administration, use of empirical clotting factor replacement therapy, neuroimaging and timing of hematology consultation.
  
  
  METHODS
  Hematologists and neonatologists/paediatricians, identified from membership lists of Canadian professional organizations, were provided electronic and/or paper versions of the survey instrument. Questions were posed in the context of specific clinical scenarios. Differences in response proportions between groups were compared for selected questions.
  
  
  RESULTS
  There were 171 respondents among 616 eligible persons who were sent the survey; 58 respondents had recent experience managing a newborn with hemophilia. There was a consensus not to provide empirical treatment to well newborns after uncomplicated deliveries, to provide empirical treatment to symptomatic newborns and to obtain neuroimaging for symptomatic newborns. Systematic differences between hematologists and neonatologists/paediatricians existed with regard to the timing of hematology consultation when the diagnosis of hemophilia had not been confirmed antenatally, the route of vitamin K administration for newborns with hemophilia and the choice of product to use for empirical treatment of a symptomatic newborn.
  
  
  CONCLUSIONS
  The observed lack of consensus regarding important management decisions indicates a need for ongoing research in the care of newborns with hemophilia. Systematic differences between hematologists and neonatologists/paediatricians suggest a role for improved communication and collaboration between these two groups of practitioners.
authors.affiliation: Division of Pediatric Hematology/Oncology, Janeway Child Health and Rehabilitation Centre, St John's, Newfoundland and Labrador, Ottawa, Ontario.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Moorehead
authors.affiliation: University of Ottawa, Ottawa, Ontario.
authors.forename: Jamie
authors.initials: J
authors.lastname: Ray
authors.affiliation: Department of Pediatrics, University of Ottawa, Ottawa, Ontario ; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Barrowman
authors.affiliation: Department of Pediatrics, University of Ottawa, Ottawa, Ontario.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Lemyre
authors.affiliation: Department of Pediatrics, University of Ottawa, Ottawa, Ontario.
authors.forename: Robert
authors.initials: R
authors.lastname: Klaassen
keywords: Hemophilia A; Hemophilia B; Intracranial hemorrhages; Neuroimaging; Newborn