Lack of Documented Prophylactic Vitamin K Administration in Newborns: Incidence, Predictors, and Bleeding Outcomes in a Large Healthcare Network Population

Objective Prophylactic vitamin K (pVitK) is recommended for all newborns to prevent vitamin K deficiency bleeding (VKDB), but reports of parental refusal are increasing. This study describes the possible drivers of no documented pVitK in a large US hospital network. Study Design This retrospective cohort study consisted of full-term newborns born between 2017 and 2022, admitted to HCA Healthcare network facilities. Results 884 876 newborns across 116 hospitals were included. 19 384 had no documented pVitK (2.2%). Using a multivariable model, having no documented pVitK was significantly associated with suspected VKDB bleeding (p < 0.01). Gestational age, maternal parity, maternal race, maternal ethnicity, and insurance type were the greatest predictors of lack of documented pVitK. Conclusion A lack of documented pVitK was associated with gestational age, maternal race and ethnicity, and an increased risk of suspected VKDB. This study identified areas for improved documentation and parental education.