Specific Mortality Data from 2017-Present is Not Available in the Provided Evidence
The evidence provided does not contain year-by-year mortality statistics for vitamin K deficiency bleeding (VKDB) in the United States from 2017 to present. However, I can provide you with the critical epidemiological data and context from the available evidence.
What We Know About VKDB Incidence and Mortality
Without Vitamin K Prophylaxis:
- Early and classic VKDB: 250-1,700 per 100,000 births (0.25%-1.7%) 1
- Late VKDB: 10.5-80 per 100,000 births 2
- Overall risk without prophylaxis: 1 in 59 infants (1,700/100,000) will develop VKDB 3
With Intramuscular Vitamin K Prophylaxis:
Current Trends (2013-2024)
VKDB incidence is rising in the United States, primarily due to increasing parental refusal of intramuscular vitamin K prophylaxis 2, 4:
- Refusal rates in US hospitals: 0%-3.2% 2
- Refusal rates in home births: up to 14.5% 2
- Refusal rates in birthing centers: up to 31.0% 2
Mortality and Morbidity Data:
A 2014 case series over 8 months identified 7 infants with vitamin K deficiency (none received prophylaxis at birth) 5:
- 4 of 7 (57%) developed intracranial hemorrhage
- 2 required urgent neurosurgical intervention
- Mean age at presentation: 10.3 weeks
A 2021 prospective 5-year study found 6:
- Lethality rate: 23% among infants with late VKDB
- Neurological complications: 21% of survivors
- Intracranial hemorrhage occurred in 32% of cases
Critical Clinical Context
The American Academy of Pediatrics designated public education about intramuscular vitamin K administration as a public health priority in 2019 2, specifically because of reports linking parental refusal to VKDB cases.
Common Pitfalls:
- Oral vitamin K is less effective than intramuscular administration and does not provide adequate protection against late VKDB, even with multiple doses 2, 7
- Exclusively breastfed infants remain at risk for late VKDB even after receiving intramuscular vitamin K at birth, particularly after hospital discharge 7
- Secondary VKDB (83% of cases) is more common than primary VKDB and involves additional risk factors beyond lack of prophylaxis 6
Why Exact Annual US Mortality Numbers Aren't Available:
VKDB has become rare enough with widespread prophylaxis that individual cases are reported as case series rather than tracked in annual national mortality statistics. The evidence shows this is a preventable disease with potentially catastrophic outcomes (death or permanent neurological disability) when prophylaxis is refused.