title: Perinatal influences on the uptake of newborn Vitamin K prophylaxis--a retrospective cohort study.
abstract: OBJECTIVE
  To describe rates of newborn vitamin K prophylaxis uptake according to method of administration (intramuscular [IM], oral, refused) and identify predictors for the choice of oral administration and for refusal of vitamin K prophylaxis.
  
  
  METHODS
  A retrospective cohort study examined the relationship between method of vitamin K administration and various exposure factors (infant, maternal, socio-demographic and healthcare professional). Written and electronic data for births from a single tertiary birthing unit in New Zealand (NZ) were examined over a four-year period from January 2009 to December 2012.
  
  
  RESULTS
  Records for 7,089 mothers/babies were examined. Of these, 92.9% of infants received IM and 5.4% oral vitamin K. Refusal of vitamin K was associated with (OR [95%CI]): Asian ethnicity (5.87 [3.61 to 9.53] p<0.001); vaginal delivery (2.85 [1.83 to 4.43] p<0.001); and gestational age, per additional week, (1.24 [1.10 to 1.39) p<0.001). Oral vitamin K was associated with (OR [95%CI]): Asian ethnicity (2.61 [1.80 to 3.79] p<0.001); obstetric nurse as the Lead Maternity Carer (LMC) (2.65 [1.73 to 4.06] p<0.001); vaginal delivery (2.34 [1.84 to 2.96] p<0.001); gestational age, per week, (1.14 [1.07 to 1.21] p<0.001); and LMC experience, per decade (0.61 [0.51 to 0.74] p<0.001).
  
  
  CONCLUSIONS
  This study reveals several important and novel associations with mode of administration of newborn vitamin K prophylaxis. IM vitamin K uptake was also lower than international data, largely due to increased oral uptake.
  
  
  CONCLUSIONS
  Uptake of vitamin K is associated with ethnicity and also factors in the infant that might imply a perceived protection against vitamin K deficiency bleeding. Further investigation is required for a fuller understanding of the motivations for choosing differing routes of vitamin K administration in newborns, with particular emphasis on factors influencing parental choice.
authors.affiliation: Dunedin School of Medicine, University of Otago, New Zealand.
authors.forename: Malihah
authors.initials: M
authors.lastname: Burke
authors.affiliation: Dunedin School of Medicine, University of Otago, New Zealand.
authors.forename: Helen
authors.initials: H
authors.lastname: Bernhardt
authors.affiliation: Department of Women's & Children's Health, University of Otago, New Zealand.
authors.forename: David M
authors.initials: DM
authors.lastname: Reith
authors.affiliation: Department of Women's & Children's Health, University of Otago, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: Barker
authors.affiliation: Department of Women's & Children's Health, University of Otago, New Zealand.
authors.forename: Roland S
authors.initials: RS
authors.lastname: Broadbent
authors.affiliation: Department of Women's & Children's Health, University of Otago, New Zealand.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Wheeler
mesh_terms: D000284:Administration, Oral; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007273:Injections, Intramuscular / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000193:education / Q000523:psychology; D009520:New Zealand; D063046:Patient Medication Knowledge; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology / Q000706:statistics & numerical data*; D014812:Vitamin K / Q000008:administration & dosage* / Q000627:therapeutic use; D006475:Vitamin K Deficiency Bleeding / Q000517:prevention & control*
chemical_list: D014812:Vitamin K
keywords: neonate; prophylaxis; vitamin K; vitamin K deficiency bleeding