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| Autori principali: | , , , , , , , , , , , , , , , |
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| Natura: | Artículo Open Access |
| Pubblicazione: |
Wiley
2025
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| Accesso online: | https://onlinelibrary.wiley.com/doi/10.1111/ped.70075 |
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- Vitamin K deficiency bleeding and optimal prophylaxis methods in biliary atresia: A surveillance study in Japan Ryuji Okubo Chiyoe Shirota Motoshi Wada Masato Shinkai Hirofumi Tomita Satoshi Umeda Hiromu Miyake Toshiharu Matsuura Shigehisa Fumino Akio Odaka Taizo Hibi Toshio Harumatsu Akiko Yokoi Tomoro Hishiki Shigeru Ono Kohei Matsushita Pediatrics International Abstract Background Vitamin K (VK) prophylaxis refers to the administration of VK to newborns to prevent neonatal VK deficiency bleeding (VKDB), which is characterized by intracranial hemorrhage (ICH). This study investigated the relationship between VK prophylaxis methods and VKDB in biliary atresia (BA). Methods The survey targeted 497 cases in the Japanese Biliary Atresia Registry between 2015 and 2019, of which 395 (79.5%) returned the questionnaire. Of the 395 patients, 289 were selected after excluding cases in which the gestational age was <36 weeks or the VK prophylaxis methods/feeding contents were unknown. The patients were categorized into two groups according to VK prophylaxis methods. We conducted a comparative study using propensity score matching. The prognosis of patients with or without ICH was also investigated. Results In the analysis, no VKDB occurred in patients using the 3‐month method. In the propensity score matching analysis, age at first visit and age at surgery were later in the three‐times method ( p = 0.018 and p = 0.022, respectively); VKDB was higher in the three‐times method than in the 3‐month method ( p = 0.029). ICH, jaundice disappearance, cholangitis, and native liver survival rates (NLSRs) were not significantly different between groups. When examining the prognosis based on ICH occurrence, the two groups showed no significant differences in jaundice disappearance, cholangitis, and NLSRs. The ICH group had a greater number of cases of delayed mental and/or motor development. Conclusions In BA, the 3‐month method is effective in preventing VKDB, and early diagnosis is crucial. 10.1111/ped.70075 http://creativecommons.org/licenses/by-nc-nd/4.0/