Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990

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2013
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Abstract
Intrapartum hypoxic events (“birth asphyxia”) may result in stillbirth, neonatal or postneonatal mortality, and impairment. Systematic morbidity estimates for the burden of impairment outcomes are currently limited. Neonatal encephalopathy (NE) following an intrapartum hypoxic event is a strong predictor of long-term impairment. Linear regression modeling was conducted on data identified through systematic reviews to estimate NE incidence and time trends for 184 countries. Meta-analyses were undertaken to estimate the risk of NE by sex of the newborn, neonatal case fatality rate, and impairment risk. A compartmental model estimated postneonatal survivors of NE, depending on access to care, and then the proportion of survivors with impairment. Separate modeling for the Global Burden of Disease 2010 (GBD2010) study estimated disability adjusted life years (DALYs), years of life with disability (YLDs), and years of life lost (YLLs) attributed to intrapartum-related events. In 2010, 1.15 million babies (uncertainty range: 0.89–1.60 million; 8.5 cases per 1,000 live births) were estimated to have developed NE associated with intrapartum events, with 96% born in low- and middle-income countries, as compared with 1.60 million in 1990 (11.7 cases per 1,000 live births). An estimated 287,000 (181,000–440,000) neonates with NE died in 2010; 233,000 (163,000–342,000) survived with moderate or severe neurodevelopmental impairment; and 181,000 (82,000–319,000) had mild impairment. In GBD2010, intrapartum-related conditions comprised 50.2 million DALYs (2.4% of total) and 6.1 million YLDs. Intrapartum-related conditions are a large global burden, mostly due to high mortality in low-income countries. Universal coverage of obstetric care and neonatal resuscitation would prevent most of these deaths and disabilities. Rates of impairment are highest in middle-income countries where neonatal intensive care was more recently introduced, but quality may be poor. In settings without neonatal intensive care, the impairment rate is low due to high mortality, which is relevant for the scale-up of basic neonatal resuscitation.
Reference Key
lee2013pediatricintrapartum-related Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Anne CC Lee;Naoko Kozuki;Hannah Blencowe;Theo Vos;Adil Bahalim;Gary L. Darmstadt;Susan Niermeyer;Matthew Ellis;Nicola J. Robertson;Simon Cousens;Joy E. Lawn;Anne CC Lee;Naoko Kozuki;Hannah Blencowe;Theo Vos;Adil Bahalim;Gary L. Darmstadt;Susan Niermeyer;Matthew Ellis;Nicola J. Robertson;Simon Cousens;Joy E. Lawn;
Journal Pediatric research
Year 2013
DOI
doi:10.1038/pr.2013.206
URL
http://dx.doi.org/10.1038/pr.2013.206
Keywords
Epidemiology neonatology hypoxic–ischaemic encephalopathy meta-analysis National Center for Biotechnology Information NCBI NLM MEDLINE review humans pubmed abstract nih national institutes of health national library of medicine research support non-u.s. gov't u.s. gov't non-p.h.s. female male N.I.H. Extramural sex factors linear models Incidence Socioeconomic Factors survival rate risk assessment morbidity historical article history 20th century 21st century global health / statistics & numerical data* central nervous system diseases / etiology asphyxia neonatorum / complications joy e lawn pmid:24366463 pmc3873711 doi:10.1038/pr.2013.206 anne c c lee naoko kozuki asphyxia neonatorum / epidemiology* asphyxia neonatorum / history central nervous system diseases / congenital* central nervous system diseases / epidemiology* central nervous system diseases / history global health / history

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