Evidence Suggests There Was Not a "Resurgence" of Kernicterus in the 1990s
Evidence Suggests There Was Not a "Resurgence" of Kernicterus in the 1990s
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DOI：
10.1542/peds.2010-2476
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发表时间：
2011-04-01
期刊：
影响因子：
8
通讯作者：
Newman, Thomas B.
中科院分区：
文献类型：
--
作者：
Brooks, Jordan C.;Fisher-Owens, Susan A.;Newman, Thomas B.
背景技术背景：虽然有些人认为，核黄疸消失在美国在20世纪70年代至80年代，并显着重现在20世纪90年代，以人口为基础的数据，以支持这样的复苏是lacked.METHODS：我们使用的诊断代码的数据收集形式从加州部的发展服务（DDS），以确定核黄疸的情况下，从1988年至1997年出生的儿童。我们研究了核黄疸死亡率的趋势，在美国从1979年到2006年使用死亡证明数据从国家卫生统计中心。这一数字被扩大，以反映婴儿死亡病例损失的估计，得出发病率估计为1/200 000加州活产，1/2500接受DDS服务的儿童，1/400脑瘫儿童。从1988年到1997年，核黄疸发病率没有显著趋势（P = 0.77）。1994年发表的AAP实践参数对健康足月婴儿高胆红素血症的发生率没有显著差异（P = 0.92）。在全国范围内，有3个报告的婴儿死于核黄疸在1994年和2个或更少的其他28年，从1979年至2006年（0.28死亡每百万活产婴儿）：有核黄疸死亡率没有显着增加在此期间。结论：数据从加州不支持核黄疸在20世纪90年代的复苏。在美国，核黄疸的死亡仍然很罕见，在过去的25年里没有明显的增加。儿科2011; 127：672-679
BACKGROUND: Although some have suggested that kernicterus disappeared in the United States in the 1970s to 1980s and dramatically reappeared in the 1990s, population-based data to support such a resurgence are lacking.METHODS: We used diagnosis codes on data collection forms from the California Department of Developmental Services (DDS) to identify kernicterus cases among children born from 1988 to 1997. We examined kernicterus mortality trends in the United States from 1979 to 2006 using death certificate data from the National Center for Health Statistics.RESULTS: We identified 25 cases of physician-diagnosed kernicterus. This figure was augmented to reflect estimates of cases lost to infant mortality, yielding incidence estimates of 1 in 200 000 California live births, 1 in 2500 among children who received services from DDS, and 1 in 400 children with cerebral palsy. There was no significant trend in kernicterus incidence from 1988 to 1997 (P = .77). Incidence before and after the 1994 publication of the AAP practice parameter for hyperbilirubinemia in healthy term infants was not significantly different (P = .92). Nationally, there were 3 reported infant deaths from kernicterus in 1994 and 2 or fewer in the other 28 years from 1979 to 2006 (0.28 deaths per million live births): there was no significant increase in kernicterus mortality over this period.CONCLUSION: Data from California do not support a resurgence of kernicterus in the 1990s. Deaths from kernicterus in the United States have remained rare, with no apparent increase during the last 25 years. Pediatrics 2011; 127:672-679