The Contribution of Neonatal Jaundice to Global Child Mortality: Findings From the GBD 2016 Study

* Abbreviations: GBD — : global burden of disease NNJ — : neonatal jaundice Rh — : rhesus SDG — : Sustainable Development Goal SDI — : Sociodemographic index UI — : uncertainty interval Neonatal jaundice (NNJ) is a transitional phenomenon affecting most newborns with largely benign consequences in the first week of life. It typically resolves within 3 to 5 days without significant complications in the absence of comorbid prematurity, sepsis, or hemolytic disorders. In some infants, NNJ may become severe enough to put them at risk for bilirubin-induced mortality or long-term neurodevelopmental impairments necessitating effective evaluation and treatment.1 However, the contribution of NNJ to the global burden of disease (GBD) remains largely unknown. Perhaps the first attempt to estimate the burden of severe NNJ was reported by Bhutani et al2 in 2013. Extreme hyperbilirubinemia (total plasma and serum bilirubin >25 mg/dL) was estimated to affect 481 000 late-preterm and term neonates annually, with 114 000 dying and >63 000 surviving with moderate or severe long-term neurologic impairments. However, the data sources were limited, and the disease burden was not compared with other prominent neonatal disorders. The prevailing United Nations’ Sustainable Development Goals (SDGs) until 2030 not only target a reduction in child mortality but also recognize disability-related issues among survivors.3 Consistent with the SDGs, the GBD collaborators led by the Institute for Health Metrics and Evaluation, USA now provide robust and periodically updated comparative estimates of fatal and non-fatal outcomes for major neonatal disorders, including NNJ. As a first step, and in contrast to common practice, “hemolytic disease and other neonatal jaundice” as … Address correspondence to Bolajoko O. Olusanya, FRCPCH, PhD, Center for Healthy Start Initiative, 286A, Corporation Dr, Dolphin Estate, Ikoyi, Lagos, Nigeria. E-mail: bolajoko.olusanya{at}uclmail.net