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Advances to diminish global newborn kernicterus mortality

Journal of Perinatology volume 44, pages 493–500 (2024)Cite this article

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A Correction to this article was published on 21 February 2024

This article has been updated

Abstract

Objective

Initiatives, “Every Newborn Action Plans” and “Sustainable Developmental Goals,” are profoundly shaping global infant mortality trends. Concurrently, professional organizations recommended curricula to prevent extreme hyperbilirubinemia (EHB) sequelae. Therefore we assessed if these efforts have successfully decreased EHB-related mortality over time.

Study Design

We used the Global Burden of Diseases 2019 database to determine neonatal and infant mortality and the burden of kernicterus from 1990–2019.

Results

Globally, kernicterus accounted for 2.8 million infant deaths and trended downwards significantly from 1990 to 2019. By 2019, kernicterus-related mortality was 4 and 293 per million livebirths in high (HICs) and low income countries (LICs), respectively. 82% of deaths occurred in LICs and lower-middle income-countries. Average declines of mortality rates were 6.2% and 3.0% for HICs and LICs, respectively.

Conclusions

Kernicterus-related mortality has been effectively reduced to <5 per million in HICs. Skills and knowledge transfer can potentially transform frontline services to bridge discordant kernicteric outcomes worldwide.

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Fig. 1: Trends in Global EHB-IMRs (0–6 days) stratified by the four World Bank Income Groups.
Fig. 2: Trends in Global EHB-IMRs (0–364 days) stratified by the four World Bank Income Groups.
Fig. 3: EHB-IMRs joinpoint trends.

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Data availability

The datasets generated and analyzed during the current study will be available upon requests to the corresponding author. GBD 2019 database is open to public via the Global Health Data Exchange (GHDx) (http://ghdx.healthdata.org). which is supported by the Institute for Health Metrics and Evaluation (IHME), University of Washington, USA.

Change history

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Acknowledgements

We thank Professor Claudio Tiribelli, MD, Ph.D. (Trieste, Italy); Iman Iskander, MD (Cairo, Egypt); Praveen Kumar, MD (Chandigarh, India); Lizhong Du, MD (Hangzhou, China); Monica Villa Guillen, MD (Mexico City, Mexico); Zubaida Farouk, MD (Kano, Nigeria); Esterlita Uy, MD (Manila, Philippines), and Numan N. Hameed, MD (Baghdad, Iraq) for their insightful comments and guidance.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA

    Vinod K. Bhutani & Ronald J. Wong

  2. Department of Neonatology, Cayuga Medical Center of Ithaca, Ithaca, NY, USA

    Ramesh Vidavalur

  3. Weill Cornell Medicine, New York, NY, USA

    Ramesh Vidavalur

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  1. Vinod K. Bhutani
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Contributions

VKB and RV conceptualized, designed, and developed the study, and drafted the initial manuscript, supervised, and performed data collection, analysis, and validation, revised the manuscript, developed Tables and Figures, and approved the final version. RJW critically reviewed the manuscript, revised the manuscript, and approved the final version as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Vinod K. Bhutani.

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The original online version of this article was revised: Table 1 including the legend has been corrected.

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Bhutani, V.K., Vidavalur, R. & Wong, R.J. Advances to diminish global newborn kernicterus mortality. J Perinatol 44, 493–500 (2024). https://doi.org/10.1038/s41372-023-01862-7

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