Intracranial hemorrhage in infants as a serious, and preventable consequence of late form of vitamin K deficiency: A selfie picture of Turkey, strategies for tomorrow

Ünal E., Ozsoylu S., Bayram A., Ozdemir M. A., Yılmaz E., Canpolat M., ...More

Child's Nervous System, vol.30, no.8, pp.1375-1382, 2014 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 30 Issue: 8
  • Publication Date: 2014
  • Doi Number: 10.1007/s00381-014-2419-2
  • Journal Name: Child's Nervous System
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1375-1382
  • Keywords: Children, Intracranial hemorrhage, Preventive measures, Turkey, Vitamin K deficiency bleeding
  • Kütahya Health Sciences University Affiliated: No


Purpose: Vitamin K deficiency bleeding is one of the most common causes of acquired hemostatic disorder in early infancy. Although vitamin K is practiced routinely after every birth in Turkey, children with type of vitamin K deficiency bleedings (L-VKDB) can be encountered. We aimed to evaluate the clinical features of the children with L-VKDB reported from Turkey. Methods: Between 1995 and 2013, 48 studies reporting 534 children with L-VKDB were evaluated in this study. Results: Of the 534 reported children (178 girls, 356 boys), 486 (91 %) were extremely breastfed. The most common bleeding sites were intracranial hemorrhage, gastrointestinal, and umbilical in 414 (77.4 %), 33 (6.2 %), and 33 (6.2 %) children, respectively, and 35 (6.6 %) children had been diagnosed incidentally without any bleeding. The etiology of 399 (74.7 %) children were classified as idiopathic, whereas 135 (25.3 %) were secondary. Intramuscular vitamin K was administered in 248 (46.4 %), not administered in 228 (42.7 %), and the administration of vitamin K were not determined in 58 (10.9 %) children. The outcomes of Turkish cohort showed that 111 (20.8) children died, 257 (48.1 %) cases developed neurologic deficit (mainly epilepsy and psychomotor retardation), and only 166 (31.1 %) patients recovered without squeal. Conclusions: The compliance of prophylactic measures in Turkey does not seem to be satisfactory. As a further measure of tomorrow, we vigorously emphasize that a national surveillance program may be initiated. An additional intramuscular dose or oral supplementation of vitamin K especially for exclusively breast-fed infants may reduce this catastrophic problem in our country. © 2014 Springer-Verlag.