Bhutani, Vinod K; Zipursky, Alvin; Blencowe, Hannah; Khanna, Rajesh; Sgro, Michael; Ebbesen, Finn; Bell, Jennifer; Mori, Rintaro; Slusher, Tina M; Fahmy, Nahed; +8 more... Paul, Vinod K; Du, Lizhong; Okolo, Angela A; de Almeida, Maria-Fernanda; Olusanya, Bolajoko O; Kumar, Praveen; Cousens, Simon; Lawn, Joy E; (2013) Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatric research, 74 Sup (Suppl ). pp. 86-100. ISSN 0031-3998 DOI: https://doi.org/10.1038/pr.2013.208
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Abstract
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.
Item Type | Article |
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Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology (-2023) |
Research Centre |
Centre for Maternal, Reproductive and Child Health (MARCH) Tropical Epidemiology Group Maternal Health Group |
PubMed ID | 24366465 |
ISI | 331157400007 |
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