Ekelund H, Finnström O, Gunnarskog J, Källén B, Larsson Y
Department of Public Health and Epidemiology, National Board of Health, Stockholm, Sweden.
BMJ. 1993 Jul 10;307(6896):89-91. doi: 10.1136/bmj.307.6896.89.
To investigate whether childhood cancer is associated with intramuscular administration of vitamin K to newborn infants.
Routines for administration of vitamin K to infants born after normal deliveries during 1973-89 were obtained from maternity hospitals. Occurrence of cancer up to the end of 1991 was identified by comparing these records with the national cancer registry. Adherence to the routine method of administering vitamin K was checked with the medical records of a sample of 396 infants (196 who had developed childhood cancer and 200 controls).
All maternity hospitals in Sweden.
1,384,424 full term infants born after non-instrumental deliveries, 1,085,654 of whom were born in units where vitamin K was routinely given by intramuscular injection and 272,080 of whom were born where it was given orally.
Odds ratios for cancer after intramuscular administration of vitamin K versus oral administration after stratification for year of birth.
Adherence to routine method of administering vitamin K was 92% in the 235 cases where individual information could be found. The risk of cancer after intramuscular administration of vitamin K was not elevated compared with that after oral administration: odds ratios of 1.01 (95% confidence interval 0.88 to 1.17) for all childhood cancers and 0.90 (0.70 to 1.16) for childhood leukaemia.
The alleged association between intramuscular vitamin K prophylaxis to newborn infants and childhood cancer could not be verified in the present study of full term infants born after non-instrumental delivery.
调查新生儿肌肉注射维生素K是否与儿童癌症有关。
从妇产医院获取1973 - 1989年正常分娩后出生婴儿的维生素K给药常规。通过将这些记录与国家癌症登记处进行比较,确定截至1991年底癌症的发生情况。通过对396名婴儿(196名患儿童癌症的婴儿和200名对照)的样本病历检查,核实维生素K给药常规方法的依从性。
瑞典所有妇产医院。
1384424名非器械分娩的足月婴儿,其中1085654名在常规通过肌肉注射给予维生素K的单位出生,272080名在通过口服给予维生素K的单位出生。
出生年份分层后,肌肉注射维生素K与口服维生素K后癌症的比值比。
在可找到个体信息的235例病例中,维生素K给药常规方法的依从率为92%。与口服给药相比,肌肉注射维生素K后患癌症的风险并未升高:所有儿童癌症的比值比为1.01(95%置信区间0.88至1.17),儿童白血病的比值比为0.90(0.70至1.16)。
在本项对非器械分娩的足月婴儿研究中,无法证实新生儿肌肉注射维生素K预防与儿童癌症之间所谓的关联。