Centre for Healthy Start Initiative, Lagos, Nigeria.
Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel; Faculty of Medicine of the Hebrew University, Jerusalem, Israel.
Lancet Child Adolesc Health. 2018 Aug;2(8):610-620. doi: 10.1016/S2352-4642(18)30139-1. Epub 2018 Jun 28.
Hyperbilirubinaemia, presenting as jaundice, is a ubiquitous and frequently benign condition in newborn babies but is a leading cause of hospitalisation in the first week of life. In some infants jaundice can become severe, progressing to acute bilirubin encephalopathy and kernicterus with a substantial risk of neonatal mortality and long-term neurodevelopmental impairments. Severe hyperbilirubinaemia and its sequelae continue to occur in industrialised countries with functioning medical systems and a disproportionately high burden also persists in low-income and middle-income countries due primarily to delays in delivering effective treatments that are routinely available in high-income countries. In this Review we summarise up-to-date evidence on the epidemiology of neonatal jaundice including its global burden based on estimates of its prevalence, and both fatal and non-fatal health outcomes. We also discuss the management of severe hyperbilirubinaemia including the prevention of kernicterus, and highlight future directions for research.
高胆红素血症,表现为黄疸,是新生儿中普遍存在且常为良性的病症,但也是新生儿生命第一周住院的主要原因。在一些婴儿中,黄疸可能会变得严重,发展为急性胆红素脑病和核黄疸,新生儿死亡率和长期神经发育损伤的风险很大。在有健全医疗体系的工业化国家,严重高胆红素血症及其后果仍然存在,而在低收入和中等收入国家,由于未能及时提供在高收入国家常规可用的有效治疗,其负担也不成比例地高。在这篇综述中,我们总结了关于新生儿黄疸的最新流行病学证据,包括根据其患病率估计的全球负担,以及致命和非致命的健康结果。我们还讨论了严重高胆红素血症的管理,包括预防核黄疸,并强调了未来的研究方向。