Pediatrics · Public Health ·
Newborn Vitamin K Nonreceipt Linked to Higher Bleeding Risk
In a retrospective US cohort of 5.24 million infants born from 2017 through 2025, nonreceipt of intramuscular vitamin K increased over time. Infants who did not receive prophylaxis had higher adjusted risks of bleeding, intracranial bleeding, and death with concurrent bleeding during the birth hospitalization.
- Vitamin K nonreceipt increased from 3.1% to 6.8%.
- Nonreceipt was associated with 47% higher adjusted bleeding risk.
- Intracranial bleeding risk was more than twice as high.
Researchers used the Epic Cosmos dataset to study infants born at 35 to 43 weeks’ gestation at hospitals and health systems across all 50 US states from 2017 through 2025. The retrospective cohort included 5,240,780 infants. The primary outcome was bleeding within the first 6 months of life, identified using ICD-10 codes; secondary outcomes included intracranial bleeding and mortality with concurrent bleeding during the birth hospitalization.
Nonreceipt of newborn intramuscular vitamin K rose from 3.1% in 2017 to 6.8% in 2025. Across the study period, bleeding by 6 months occurred at a rate of 288.0 per 10,000 infants who did not receive vitamin K, compared with 185.9 per 10,000 who did; the adjusted risk ratio was 1.47 (95% CI, 1.43-1.51). Nonreceipt was also associated with higher risks of intracranial bleeding (33.0 vs 13.2 per 10,000; adjusted risk ratio, 2.43) and mortality with concurrent bleeding during the birth hospitalization (2.9 vs 1.1 per 10,000; adjusted risk ratio, 2.69).
The findings document increasing nonreceipt alongside higher observed bleeding risks. The retrospective design and use of diagnostic codes may limit causal interpretation and outcome ascertainment; the study compares groups and does not test an intervention.
In practice
For newborns in the studied gestational-age range, nonreceipt of intramuscular vitamin K was associated with higher risks of bleeding during the first 6 months, including intracranial bleeding, than receipt. The findings reinforce the clinical importance of newborn prophylaxis, while not establishing causality because this was a retrospective cohort using coded outcomes. The results describe US births in the Epic Cosmos dataset and may not generalize to all settings or populations.
AI-generated clinical interpretation · Not editor-reviewed
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JAMA: Nonreceipt of Newborn Vitamin K and Risk of Bleeding ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.