Diala Udochukwu M, Usman Fatima, Appiah Duke, Hassan Laila, Ogundele Tolulope, Abdullahi Fatima, Satrom Katherine M, Bakker Caitlin J, Lee Burton W, Slusher Tina M
Department of Paediatrics, Faculty of Clinical Sciences, College of Health Sciences, University of Jos, University of Jos Lamingo Campus, Jos 930232, Nigeria.
Department of Paediatrics, Faculty of Clinical Services, College of Health Sciences, Bayero University, Aminu Kano Teaching Hospital Campus, Kano 700006, Nigeria.
J Clin Med. 2023 May 29;12(11):3738. doi: 10.3390/jcm12113738.
Evidence regarding the adverse burden of severe neonatal jaundice (SNJ) in hospitalized neonates in resource-constrained settings is sparse. We attempted to determine the prevalence of SNJ, described using clinical outcome markers, in all World Health Organization (WHO) regions in the world. Data were sourced from Ovid Medline, Ovid Embase, Cochrane Library, African Journals Online, and Global Index Medicus. Hospital-based studies, including the total number of neonatal admissions with at least one clinical outcome marker of SNJ, defined as acute bilirubin encephalopathy (ABE), exchange blood transfusions (EBT), jaundice-related death, or abnormal brainstem audio-evoked response (aBAER), were independently reviewed for inclusion in this meta-analysis. Of 84 articles, 64 (76.19%) were from low- and lower-middle-income countries (LMICs), and 14.26% of the represented neonates with jaundice in these studies had SNJ. The prevelance of SNJ among all admitted neonates varied across WHO regions, ranging from 0.73 to 3.34%. Among all neonatal admissions, SNJ clinical outcome markers for EBT ranged from 0.74 to 3.81%, with the highest percentage observed in the African and South-East Asian regions; ABE ranged from 0.16 to 2.75%, with the highest percentages observed in the African and Eastern Mediterranean regions; and jaundice-related deaths ranged from 0 to 1.49%, with the highest percentage observed in the African and Eastern Mediterranean regions. Among the cohort of neonates with jaundice, the prevalence of SNJ ranged from 8.31 to 31.49%, with the highest percentage observed in the African region; EBT ranged from 9.76 to 28.97%, with the highest percentages reported for the African region; ABE was highest in the Eastern Mediterranean (22.73%) and African regions (14.51%). Jaundice-related deaths were 13.02%, 7.52%, 2.01% and 0.07%, respectively, in the Eastern Mediterranean, African, South-East Asian and European regions, with none reported in the Americas. aBAER numbers were too small, and the Western Pacific region was represented by only one study, limiting the ability to make regional comparisons. The global burden of SNJ in hospitalized neonates remains high, causing substantial, preventable morbidity and mortality especially in LMICs.
关于资源受限环境中住院新生儿严重新生儿黄疸（SNJ）不良负担的证据很少。我们试图确定全球所有世界卫生组织（WHO）区域中使用临床结局指标描述的SNJ患病率。数据来源于Ovid Medline、Ovid Embase、Cochrane图书馆、非洲期刊在线和全球医学索引。纳入本荟萃分析的研究为基于医院的研究，包括至少有一项SNJ临床结局指标（定义为急性胆红素脑病（ABE）、换血疗法（EBT）、黄疸相关死亡或异常脑干听觉诱发电位（aBAER））的新生儿入院总数。在84篇文章中，64篇（76.19%）来自低收入和中低收入国家（LMICs），这些研究中14.26%的黄疸新生儿患有SNJ。WHO各区域所有入院新生儿中SNJ的患病率各不相同，范围从0.73%到3.34%。在所有新生儿入院病例中，EBT的SNJ临床结局指标范围从0.74%到3.81%，在非洲和东南亚区域观察到的百分比最高；ABE范围从0.16%到2.75%，在非洲和东地中海区域观察到的百分比最高；黄疸相关死亡范围从0到1.49%，在非洲和东地中海区域观察到的百分比最高。在黄疸新生儿队列中，SNJ的患病率范围从8.31%到31.49%，在非洲区域观察到的百分比最高；EBT范围从9.76%到28.97%，非洲区域报告的百分比最高；ABE在东地中海（22.73%）和非洲区域（14.51%）最高。东地中海、非洲、东南亚和欧洲区域的黄疸相关死亡率分别为13.02%、7.52%、2.01%和0.07%，美洲未报告。aBAER的数据太少，西太平洋区域仅由一项研究代表，限制了进行区域比较的能力。住院新生儿中SNJ的全球负担仍然很高，尤其是在LMICs中，导致大量可预防的发病和死亡。
