ABSTRACT 310

Abstract

Background and aims: Late Vitamin K Deficiency Bleeding (VKDB) continues to be a cause of infant mortality with increased promotion of exclusive breast feeding and controversies over the administration of vitamin K. Aims: To describe the clinical profile of infants with late VKDB and determine the neurodevelopmental outcome of the survivors. Methods: Data of infants admitted with a diagnosis of VKDB or Late Hemorrhagic Disease of the Newborn between the years 2008–2011 was retrieved from the hospital’s computerized database. Surviving infants were followed up at a single visit. Results: Twenty four infants, 22 (91.7%) of them boys were identified. While 66% were between 31–60 days, 20% were between 7–30 days of life at presentation. The mean duration of illness was 1.9(range: 0.5–7) days. 58.3% had received vitamin K intramuscularly/ orally surely. 70.8% were exclusively breast fed. Cholestasis was present in 33%. 91.6% of infants had intracranial bleed, subdural in 41.7%, followed by parenchymal in 29.8%. 20.8% underwent decompressive craniectomy. 15 (62.5%) survived to hospital discharge. Of the 14 surviving infants who were followed up, 9 (64%) had developmental sequelae, of whom 2 (14.2%) had severe neurological sequelae. Conclusions: Intracranial hemorrhage caused by VKDB occurring despite vitamin K administration in the neonatal period continues to be seen among our ICU patients. Mortality and morbidity are significant. Role of a second dose of vitamin K, its time of administration and maternal supplementation of vitamin K to prevent late VKDB need to be evaluated.