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Advances to diminish global newborn kernicterus mortality
Vinod K Bhutani1, Ramesh Vidavalur2,3, Ronald J Wong4
1Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA. bhutani@stanford.edu.
Summary
Global initiatives have significantly reduced extreme hyperbilirubinemia (EHB) related infant deaths, especially in high-income countries. However, disparities persist, highlighting the need for knowledge transfer to low-income nations.
Area of Science:
- Global Health
- Neonatal Mortality
- Public Health Initiatives
Background:
- Global infant mortality trends are influenced by initiatives like Every Newborn Action Plans and Sustainable Developmental Goals.
- Professional organizations have recommended curricula to prevent extreme hyperbilirubinemia (EHB) sequelae.
- Assessing the impact of these efforts on EHB-related mortality is crucial.
Purpose of the Study:
- To evaluate the effectiveness of global initiatives and recommended curricula in decreasing extreme hyperbilirubinemia (EHB)-related mortality over time.
- To analyze trends in kernicterus-related mortality from 1990 to 2019.
Main Methods:
- Utilized the Global Burden of Diseases 2019 database.
- Determined neonatal and infant mortality rates.
- Assessed the burden of kernicterus from 1990 to 2019.
Main Results:
- Globally, kernicterus accounted for 2.8 million infant deaths, with a significant downward trend from 1990 to 2019.
- In 2019, kernicterus-related mortality was 4 per million livebirths in high-income countries (HICs) and 293 per million in low-income countries (LICs).
- 82% of deaths occurred in LICs and lower-middle-income countries, with average mortality rate declines of 6.2% in HICs and 3.0% in LICs.
Conclusions:
- Kernicterus-related mortality has been significantly reduced to less than 5 per million in HICs.
- Disparities in kernicterus outcomes persist between high-income and low-income countries.
- Skills and knowledge transfer are essential to improve frontline services and reduce kernicteric outcomes globally.
