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Title: Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels
Authors: Bhutani, Vinod K.
Zipursky, Alvin
Blencowe, Hannah
Khanna, Rajesh
Sgro, Michael
Ebbesen, Finn
Bell, Jennifer
Mori, Rintaro
Slusher, Tina M.
Fahmy, Nahed
Paul, Vinod K.
Du, Lizhong
Okolo, Angela A.
Almeida, Maria-Fernanda de [UNIFESP]
Olusanya, Bolajoko O.
Kumar, Praveen
Cousens, Simon
Lawn, Joy E.
Hosp Sick Children
Stanford Univ
London Sch Hyg & Trop Med
Saving Newborn Lives Save Children
St Michaels Hosp
Aalborg Univ Hosp
Natl Ctr Child Hlth & Dev
Univ Minnesota
Kasr Al Aini Univ
All India Inst Med Sci
Zhejiang Univ
Nigerian Soc Neonatal Med
Universidade Federal de São Paulo (UNIFESP)
Ctr Hlth Start Initiat
Post Grad Inst Med Educ & Res
Issue Date: 1-Dec-2013
Publisher: Nature Publishing Group
Citation: Pediatric Research. New York: Nature Publishing Group, v. 74, p. 86-100, 2013.
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 >= 32wk 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.
ISSN: 0031-3998
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