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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1] Programme for Global Paediatric Research (PGPR), Hospital for Sick Children, Toronto, Ontario, Canada [2] Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Children's Hospital, Stanford, California.
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Bhutani
authors.affiliation: Programme for Global Paediatric Research (PGPR), Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Alvin
authors.initials: A
authors.lastname: Zipursky
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Blencowe
authors.affiliation: Saving Newborn Lives/Save the Children, New Delhi, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Khanna
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute & Department of Paediatrics, St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Sgro
authors.affiliation: Department of Pediatrics, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Ebbesen
authors.affiliation: Programme for Global Paediatric Research (PGPR), Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bell
authors.affiliation: Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mori
authors.affiliation: 1] Programme for Global Paediatric Research (PGPR), Hospital for Sick Children, Toronto, Ontario, Canada [2] Center for Global Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Tina M
authors.initials: TM
authors.lastname: Slusher
authors.affiliation: Department of Pediatrics, Kasr Al Aini University, El Mounira Children's Hospital, Cairo, Egypt.
authors.forename: Nahed
authors.initials: N
authors.lastname: Fahmy
authors.affiliation: WHO Collaborating Centre for Training & Research in Newborn Care, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Paul
authors.affiliation: The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, The People's Republic of China.
authors.forename: Lizhong
authors.initials: L
authors.lastname: Du
authors.affiliation: Nigerian Society of Neonatal Medicine, Lagos, Nigeria.
authors.forename: Angela A
authors.initials: AA
authors.lastname: Okolo
authors.affiliation: Federal University of São Paulo-UNIFESP, São Paulo, Brazil.
authors.forename: Maria-Fernanda
authors.initials: MF
authors.lastname: de Almeida
authors.affiliation: Center for Healthy Start Initiative, Lagos, Nigeria.
authors.forename: Bolajoko O
authors.initials: BO
authors.lastname: Olusanya
authors.affiliation: Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Saving Newborn Lives/Save the Children, New Delhi, India.
authors.forename: Simon
authors.initials: S
authors.lastname: Cousens
authors.affiliation: 1] Centre for Maternal Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, UK [2] Saving Newborn Lives/Save the Children, Washington, DC.
authors.forename: Joy E
authors.initials: JE
authors.lastname: Lawn
mesh_terms: D004899:Erythroblastosis, Fetal / Q000453:epidemiology* / Q000209:etiology / Q000266:history; D014943:Global Health / Q000706:statistics & numerical data*; D049674:History, 21st Century; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000453:epidemiology* / Q000266:history; D015994:Incidence; D007231:Infant, Newborn; D015233:Models, Statistical; D012203:Rh Isoimmunization / Q000150:complications / Q000453:epidemiology* / Q000266:history