Canadian Paediatric Surveillance Program confirms low incidence of hemorrhagic disease of the newborn in Canada.

objectivesTo determine the incidence of hemorrhagic disease of the newborn (HDNB) in Canada and its relationship to the administration of vitamin K(1) (hereafter referred to as vitamin K) following birth.

methodsThe Canadian Paediatric Surveillance Program sent monthly surveys to over 2100 Canadian paediatricians requesting identification of infants with defined criteria for HDNB. Reports were confirmed with subsequent case-specific data, including coagulation test results.

resultsOf the 26 reports (10 in 1997, eight in 1998, four in 1999, four in 2000), two were from before the start of the study, three were duplicate reports, four cases erroneously identified hemolytic disease of the newborn, three had coagulation studies which were normal or not done, and seven had other disorders with bleeding. Of the six confirmed cases of infants with HDNB (one classic, five late), all had intracranial bleeding and five suffered neurological sequelae. The estimated incidence of HDNB in Canada (including infants who had oral vitamin K prophylaxis or did not receive vitamin K) is approximately 0.45/100,000.

conclusionThis study confirmed the relatively low incidence of HDNB in Canada and validated the Canadian Paediatric Society's recommendation that all newborns should be given intramuscular vitamin K shortly following birth. To alleviate confusion with haemolytic disease of the newborn, Britain and Australia modified the title of their subsequent HDNB study to vitamin K deficiency bleeding.