Efficacy of the Triple-Dose Prophylactic Vitamin K Regimen in Healthy Neonates and Evaluation of the Utility of Vitamin K Deficiency Screening

Background: In Japan, three doses of vitamin K are administered to neonates as prophylactic regimens against vitamin K deficiency bleeding (VKDB). In this study, we aimed to evaluate the efficacy of this prophylactic vitamin K regimen using the hepaplastin test (HPT) performed one, two weeks, and one month after birth. The secondary aim of this study was to evaluate the utility of HPT screening in healthy neonates.

Method: This study included a retrospective analysis of HPT values in neonates born between June 2009 and February 2018 using the prophylactic regimen implemented in 2011.

Results: The study group included 6075 neonates, of whom 274 (4.5%) had a low HPT value (<40%) at the time of discharge (approximately one week after birth). Follow-up HPT was performed in 118 neonates at two weeks, with a low HPT value persisting in 11 neonates (9%). There was no effect of breast or formula milk on HPT values, and all neonates achieved an HPT value >40% at one month, regardless of whether vitamin K supplementation was provided at two weeks. None of the infants had underlying diseases that led to secondary VKDB.

Conclusion: Healthy newborns maintained adequate HPT values with the triple-dose vitamin K administration, regardless of the feeding method. Therefore, HPT screening might not be essential for healthy neonates.