Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance

Details

• Alternative Title:
  Matern Child Health J
• Personal Author:
  Marcewicz, Lauren H. ; Clayton, Joshua ; Maenner, Matthew ; Odom, Erika ; Okoroh, Ekwutosi ; Christensen, Deborah ; Goodman, Alyson ; Warren, Michael D. ; Traylor, Julie ; Miller, Angela ; Jones, Timothy ; Dunn, John ; Schaffner, William ; Grant, Althea
  More +
• Description:
  Objectives ; Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. ; Methods ; Chart reviews were conducted at Nashville-area hospitals for 2011-2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. ; Results ; At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. ; Conclusions for Practice ; Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation.
• Subjects:
  • Adult
  • Birthing Centers
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Parents
  • Retrospective Studies
  • Surveys and Questionnaires
  • Vaccination Hesitancy
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• Source:
  Matern Child Health J. 21(5):1079-1084.
• Pubmed ID:
  28054156
• Pubmed Central ID:
  PMC5526450
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Genre:
  Journal Article
• Place as Subject:
  Tennessee
• Volume:
  21
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/46897/cdc_46897_DS1.pdf
• File Type:
  [PDF - 58.76 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:28190ecc9f3e7baebe2e88f4b340bdd11932f5af2ace133d1fc156ce702f41c2bc23a6ca11b4a0a757f9e5f76589dd3bf9d76d939ebfed55a6c76fea039f42dc