Neonatal hyperbilirubinemia and rhesus disease of the newborn: Incidence and impairment estimates for 2010 at regional and global levels

Vinod K. Bhutani, Alvin Zipursky, Hannah Blencowe, Rajesh Khanna, Michael Sgro, Finn Ebbesen, Jennifer Bell, Rintaro Mori, Tina M. Slusher, Nahed Fahmy, Vinod K. Paul, Lizhong Du, Angela A. Okolo, Maria Fernanda De Almeida, Bolajoko O. Olusanya, Praveen Kumar, Simon Cousens, Joy E. Lawn

Research output: Contribution to journalArticle

119 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)86-100
Number of pages15
JournalPediatric Research
Volume74
Issue numberSUPPL. 1
DOIs
StatePublished - Dec 1 2013

Fingerprint

Neonatal Hyperbilirubinemia
Kernicterus
Uncertainty
Hyperbilirubinemia
Newborn Infant
Incidence
Live Birth
Survivors
Eastern Europe
Stillbirth
Asian Americans
Mortality
Africa South of the Sahara
Infant Mortality
Gestational Age
Meta-Analysis

Cite this

Bhutani, V. K., Zipursky, A., Blencowe, H., Khanna, R., Sgro, M., Ebbesen, F., ... Lawn, J. E. (2013). Neonatal hyperbilirubinemia and rhesus disease of the newborn: Incidence and impairment estimates for 2010 at regional and global levels. Pediatric Research, 74(SUPPL. 1), 86-100. https://doi.org/10.1038/pr.2013.208

Neonatal hyperbilirubinemia and rhesus disease of the newborn : Incidence and impairment estimates for 2010 at regional and global levels. / 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.; De Almeida, Maria Fernanda; Olusanya, Bolajoko O.; Kumar, Praveen; Cousens, Simon; Lawn, Joy E.

In: Pediatric Research, Vol. 74, No. SUPPL. 1, 01.12.2013, p. 86-100.

Research output: Contribution to journalArticle

Bhutani, VK, Zipursky, A, Blencowe, H, Khanna, R, Sgro, M, Ebbesen, F, Bell, J, Mori, R, Slusher, TM, Fahmy, N, Paul, VK, Du, L, Okolo, AA, De Almeida, MF, Olusanya, BO, Kumar, P, Cousens, S & Lawn, JE 2013, 'Neonatal hyperbilirubinemia and rhesus disease of the newborn: Incidence and impairment estimates for 2010 at regional and global levels', Pediatric Research, vol. 74, no. SUPPL. 1, pp. 86-100. https://doi.org/10.1038/pr.2013.208
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. ; De Almeida, Maria Fernanda ; Olusanya, Bolajoko O. ; Kumar, Praveen ; Cousens, Simon ; Lawn, Joy E. / Neonatal hyperbilirubinemia and rhesus disease of the newborn : Incidence and impairment estimates for 2010 at regional and global levels. In: Pediatric Research. 2013 ; Vol. 74, No. SUPPL. 1. pp. 86-100.
@article{5136e4ab36c540778e36f75bc28f76df,
title = "Neonatal hyperbilirubinemia and rhesus disease of the newborn: Incidence and impairment estimates for 2010 at regional and global levels",
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.",
author = "Bhutani, {Vinod K.} and Alvin Zipursky and Hannah Blencowe and Rajesh Khanna and Michael Sgro and Finn Ebbesen and Jennifer Bell and Rintaro Mori and Slusher, {Tina M.} and Nahed Fahmy and Paul, {Vinod K.} and Lizhong Du and Okolo, {Angela A.} and {De Almeida}, {Maria Fernanda} and Olusanya, {Bolajoko O.} and Praveen Kumar and Simon Cousens and Lawn, {Joy E.}",
year = "2013",
month = "12",
day = "1",
doi = "10.1038/pr.2013.208",
language = "English (US)",
volume = "74",
pages = "86--100",
journal = "Pediatric Research",
issn = "0031-3998",
publisher = "Lippincott Williams and Wilkins",
number = "SUPPL. 1",

}

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 - 2013/12/1

Y1 - 2013/12/1

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

VL - 74

SP - 86

EP - 100

JO - Pediatric Research

JF - Pediatric Research

SN - 0031-3998

IS - SUPPL. 1

ER -