Advances to Diminish Global Newborn Kernicterus Mortality

Abstract

Abstract Initiatives such as “Every Newborn Action Plans” and “Sustainable Developmental Goals” have spurred comprehensive analysis of infant mortality including extreme hyperbilirubinemia. Trends in adverse outcomes over the last three decades (1990-2019). demonstrate differential rates of decline among countries’ stratified healthcare economies. Globally, Kernicterus was responsible for 2.8 (95% UI:2.3, 3.3) million infant deaths (0.07%). In 2019, kernicterus mortality was 4 per million live births for high-income-countries, which was discordant with 293 per million in low-income-countries. Approximately 60% of mortality occurred at age <6 days; 82% of deaths low and low-middle--income-countries. These countries experienced ~43,510 preventable deaths. The average decline rate was 6.2% for high-income-countries and only 3.0% for low-income-countries. Equitable outcomes of kernicteric mortality could be feasible through global dissemination of optimized and standardized systems strategies to manage newborn jaundice; declining trends in adverse neonatal and infant outcomes will require critical surveillance and clinical accountability to bridge discordant gaps.