vit k

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Risk From Vitamin K Injections?

LONDON (Reuters) -- Four papers in the current British Medical Journal

examine the

possible association between the risk of childhood leukaemia and the

administration of

intramuscular vitamin K to babies, but the results, taken together, are

inconclusive. The

UK papers were prompted by research in the early 1990s, in which Dr. Jean

Golding of

the University of Bristol reported a possible doubling of the risk of

childhood cancers

following the administration of vitamin K injections to newborns.

Newborn babies tend to have low levels of vitamin K, which aids blood

clotting. An

injection of the vitamin is commonly given to babies to reduce risk of

internal bleeding.

Dr. A. McKinney and colleagues from the Agency for the National

Health

Service in Edinburgh could not confirm an association between childhood

cancers,

including acute lymphoblastic leukaemia, and vitamin K injections to

newborns. Their

population-based, case-control study is based on data taken from hospital

records of

more than 1,000 ish children up to the age of 14 years.

However, in a retrospective case-control study of more than 3,000 English

children

under the age of 15, Dr. Louise and colleagues from the University

of Newcastle

upon Tyne, UK, found " a raised odds ratio " for acute lymphoblastic

leukaemia among 1

to 6 year olds who have received vitamin K injections. The authors say

their study

suggests " ...that there could be a significant increase in this form of

leukaemia in early

childhood among babies given intramuscular prophylaxis at birth. "

and colleagues caution that there still is no evidence that a 1

milligram injection

of vitamin K is carcinogenic. But the raised odds ratio for the subgroup

of 1 to 6 year

olds suggests that consideration should be given to use of oral, rather

than

intramuscular, vitamin K. " If it could be shown that oral administration

is as effective as

intramuscular prophylaxis in abolishing the risk of late vitamin K

deficiency bleeding,

many clinicians would now choose oral prophylaxis, " they conclude.

In the other two papers, Dr. S. Jane Passmore and colleagues from the

Childhood

Cancer Research Group in Oxford, UK, say they cannot exclude a risk of

childhood

cancers, but conclude, based on their data, that the risk cannot be

large.

Analysing data from a case-control and an ecological study in the UK,

Passmore and

colleagues write that the " ... lack of consistency between the various

studies so far

published, including this one, and the low relative risks found in most

of them suggest

that the risk, if any, attributable to the use of vitamin K cannot be

large, but the possibility

that there is some risk cannot be excluded. "

The Golding study and subsequent research has prompted the Department of

Health to

commission a meta-analysis on the subject, McKinney told Reuters. She

said the

meta-analysis should be completed by early 1999. SOURCE: British Medical

Journal

(1998;316:173-192)

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