Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels.
Pediatr Res
; 74 Suppl 1: 86-100, 2013 Dec.
Article
em En
| MEDLINE
| ID: mdl-24366465
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Isoimunização Rh
/
Saúde Global
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Eritroblastose Fetal
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Hiperbilirrubinemia Neonatal
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article