TY - JOUR
T1 - Neonatal hyperbilirubinemia and rhesus disease of the newborn
T2 - Incidence and impairment estimates for 2010 at regional and global levels
AU - Bhutani, Vinod K.
AU - Zipursky, Alvin
AU - Blencowe, Hannah
AU - Khanna, Rajesh
AU - Sgro, Michael
AU - Ebbesen, Finn
AU - Bell, Jennifer
AU - Mori, Rintaro
AU - Slusher, Tina M.
AU - Fahmy, Nahed
AU - Paul, Vinod K.
AU - Du, Lizhong
AU - Okolo, Angela A.
AU - De Almeida, Maria Fernanda
AU - Olusanya, Bolajoko O.
AU - Kumar, Praveen
AU - Cousens, Simon
AU - Lawn, Joy E.
PY - 2013/12
Y1 - 2013/12
N2 - Background: Rhesus (Rh) disease and extreme hyperbilirubinemia (EHB) result in neonatal mortality and long-term neurodevelopmental impairment, yet there are no estimates of their burden. Methods: Systematic reviews and meta-analyses were undertaken of national prevalence, mortality, and kernicterus due to Rh disease and EHB. We applied a compartmental model to estimate neonatal survivors and impairment cases for 2010. Results: Twenty-four million (18% of 134 million live births ≥32 wk gestational age from 184 countries; uncertainty range: 23-26 million) were at risk for neonatal hyperbilirubinemia-related adverse outcomes. Of these, 480,700 (0.36%) had either Rh disease (373,300; uncertainty range: 271,800-477,500) or developed EHB from other causes (107,400; uncertainty range: 57,000-131,000), with a 24% risk for death (114,100; uncertainty range: 59,700-172,000), 13% for kernicterus (75,400), and 11% for stillbirths. Three-quarters of mortality occurred in sub-Saharan Africa and South Asia. Kernicterus with Rh disease ranged from 38, 28, 28, and 25/100,000 live births for Eastern Europe/Central Asian, sub-Saharan African, South Asian, and Latin American regions, respectively. More than 83% of survivors with kernicterus had one or more impairments. Conclusion: Failure to prevent Rh sensitization and manage neonatal hyperbilirubinemia results in 114,100 avoidable neonatal deaths and many children grow up with disabilities. Proven solutions remain underused, especially in low-income countries.
AB - Background: Rhesus (Rh) disease and extreme hyperbilirubinemia (EHB) result in neonatal mortality and long-term neurodevelopmental impairment, yet there are no estimates of their burden. Methods: Systematic reviews and meta-analyses were undertaken of national prevalence, mortality, and kernicterus due to Rh disease and EHB. We applied a compartmental model to estimate neonatal survivors and impairment cases for 2010. Results: Twenty-four million (18% of 134 million live births ≥32 wk gestational age from 184 countries; uncertainty range: 23-26 million) were at risk for neonatal hyperbilirubinemia-related adverse outcomes. Of these, 480,700 (0.36%) had either Rh disease (373,300; uncertainty range: 271,800-477,500) or developed EHB from other causes (107,400; uncertainty range: 57,000-131,000), with a 24% risk for death (114,100; uncertainty range: 59,700-172,000), 13% for kernicterus (75,400), and 11% for stillbirths. Three-quarters of mortality occurred in sub-Saharan Africa and South Asia. Kernicterus with Rh disease ranged from 38, 28, 28, and 25/100,000 live births for Eastern Europe/Central Asian, sub-Saharan African, South Asian, and Latin American regions, respectively. More than 83% of survivors with kernicterus had one or more impairments. Conclusion: Failure to prevent Rh sensitization and manage neonatal hyperbilirubinemia results in 114,100 avoidable neonatal deaths and many children grow up with disabilities. Proven solutions remain underused, especially in low-income countries.
UR - http://www.scopus.com/inward/record.url?scp=84890939374&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890939374&partnerID=8YFLogxK
U2 - 10.1038/pr.2013.208
DO - 10.1038/pr.2013.208
M3 - Article
C2 - 24366465
AN - SCOPUS:84890939374
SN - 0031-3998
VL - 74
SP - 86
EP - 100
JO - Pediatric Research
JF - Pediatric Research
IS - SUPPL. 1
ER -