Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels.
Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels.
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DOI：
10.1038/pr.2013.208
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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：
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.
恒河猴（Rh）病和极端高胆红素血症（EHB）导致新生儿死亡和长期神经发育障碍，但没有估计其负担。对全国Rh病和EHB的患病率、死亡率和核黄疸进行了系统评价和荟萃分析。我们应用房室模型来估计2010年新生儿存活率和损伤病例。2400万（184个国家1.34亿胎龄≥32周活产婴儿的18%;不确定范围：2300万-2600万）存在新生儿高胆红素血症相关不良结局的风险。其中，480，700人（0.36%）患有Rh疾病（373，300;不确定性范围：271，800 - 477，500）或其他原因导致的EHB（107，400;不确定范围：57，000 - 131，000），死亡风险为24%（114，100;不确定范围：59，700 - 172，000），核黄疸风险为13%（75，400），死产风险为11%。四分之三的死亡发生在撒哈拉以南非洲和南亚。在东欧/中亚、撒哈拉以南非洲、南亚和拉丁美洲地区，Rh病核黄疸的范围分别为38、28、28和25/100，000活产。超过83%的核黄疸幸存者有一个或多个损伤。未能预防Rh致敏和管理新生儿高胆红素血症导致114，100例可避免的新生儿死亡，许多儿童长大后残疾。可持续发展解决方案仍然没有得到充分利用，特别是在低收入国家。
Rhesus (Rh) disease and extreme hyperbilirubinemia (EHB) result in neonatal mortality and long-term neurodevelopmental impairment, yet there are no estimates of their burden. 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. 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. 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.
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3.8
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Ebbesen, F
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