Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990.
Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990.
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DOI：
10.1038/pr.2013.206
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发表时间：
2013-12
影响因子：
3.6
通讯作者：
Lawn, Joy E.
中科院分区：
文献类型：
--
作者：
Lee, Anne C. C.;Kozuki, Naoko;Blencowe, Hannah;Vos, Theo;Bahalim, Adil;Darmstadt, Gary L.;Niermeyer, Susan;Ellis, Matthew;Robertson, Nicola J.;Cousens, Simon;Lawn, Joy E.
产时缺氧事件（“出生窒息”）可能导致死胎、新生儿或新生儿后期死亡和损伤。系统的发病率估计的损害结果的负担目前是有限的。分娩期缺氧事件后的新生儿脑病（NE）是长期损伤的有力预测因素。对通过系统评价确定的数据进行线性回归建模，以估计184个国家的NE发病率和时间趋势。进行荟萃分析，以估计新生儿性别，新生儿病死率和损害风险的NE的风险。房室模型估计新生儿后NE的幸存者，这取决于获得护理，然后与损害的幸存者的比例。2010年全球疾病负担（GBD 2010）研究的单独建模估计了归因于住院期间相关事件的残疾调整生命年（DLDs）、残疾生命年（YLD）和寿命损失年（YLL）。2010年，估计有115万名婴儿（不确定范围：89 - 160万;每1 000例活产8.5例）患上了与产时事件相关的NE，其中96%出生在低收入和中等收入国家，而1990年为160万（每1 000例活产11.7例）。2010年，估计有287，000（181，000 - 440，000）例NE新生儿死亡; 233，000（163，000 - 342，000）例存活，伴有中度或重度神经发育障碍; 181，000（82，000 - 319，000）例轻度障碍。在GBD 2010中，与部分相关的疾病包括5020万丹麦克朗（占总数的2.4%）和610万日元。产时相关疾病是一个巨大的全球负担，主要是由于低收入国家的高死亡率。普及产科护理和新生儿复苏将防止大多数死亡和残疾。在中等收入国家，新生儿重症监护的实施时间较晚，但质量可能较差，因此，新生儿功能障碍的发生率最高。在没有新生儿重症监护的情况下，由于死亡率高，损伤率低，这与基本新生儿复苏的规模扩大有关。
Intrapartum hypoxic events (“birth asphyxia”) may result in stillbirth, neonatal or postneonatal mortality, and impairment. Systematic morbidity estimates for the burden of impairment outcomes are currently limited. Neonatal encephalopathy (NE) following an intrapartum hypoxic event is a strong predictor of long-term impairment. Linear regression modeling was conducted on data identified through systematic reviews to estimate NE incidence and time trends for 184 countries. Meta-analyses were undertaken to estimate the risk of NE by sex of the newborn, neonatal case fatality rate, and impairment risk. A compartmental model estimated postneonatal survivors of NE, depending on access to care, and then the proportion of survivors with impairment. Separate modeling for the Global Burden of Disease 2010 (GBD2010) study estimated disability adjusted life years (DALYs), years of life with disability (YLDs), and years of life lost (YLLs) attributed to intrapartum-related events. In 2010, 1.15 million babies (uncertainty range: 0.89–1.60 million; 8.5 cases per 1,000 live births) were estimated to have developed NE associated with intrapartum events, with 96% born in low- and middle-income countries, as compared with 1.60 million in 1990 (11.7 cases per 1,000 live births). An estimated 287,000 (181,000–440,000) neonates with NE died in 2010; 233,000 (163,000–342,000) survived with moderate or severe neurodevelopmental impairment; and 181,000 (82,000–319,000) had mild impairment. In GBD2010, intrapartum-related conditions comprised 50.2 million DALYs (2.4% of total) and 6.1 million YLDs. Intrapartum-related conditions are a large global burden, mostly due to high mortality in low-income countries. Universal coverage of obstetric care and neonatal resuscitation would prevent most of these deaths and disabilities. Rates of impairment are highest in middle-income countries where neonatal intensive care was more recently introduced, but quality may be poor. In settings without neonatal intensive care, the impairment rate is low due to high mortality, which is relevant for the scale-up of basic neonatal resuscitation.
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影响因子：
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