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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.|
Slusher, Tina M.
Paul, Vinod K.
Okolo, Angela A.
Almeida, Maria-Fernanda de [UNIFESP]
Olusanya, Bolajoko O.
Lawn, Joy E.
Hosp Sick Children
London Sch Hyg & Trop Med
Saving Newborn Lives Save Children
St Michaels Hosp
Aalborg Univ Hosp
Natl Ctr Child Hlth & Dev
Kasr Al Aini Univ
All India Inst Med Sci
Nigerian Soc Neonatal Med
Universidade Federal de São Paulo (UNIFESP)
Ctr Hlth Start Initiat
Post Grad Inst Med Educ & Res
|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.|
|Appears in Collections:||Em verificação - Geral|
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