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For the most part, in the developed world, neonatal jaundice occurs without significant morbidity and/or mortality due to early diagnosis and treatment.1 However, most literature from low-middle-income countries (LMICs) suggests that it accounts for significant morbidity and mortality in contrast to that in the United States and developed world (Table 13-1).218 For example, based on limited population-based data available worldwide, severe neonatal jaundice is about 100-fold greater in Nigeria than in the developed world. In one of the few population-based studies from the developed world, Ebbesen et al.17 from Denmark reported that 24/100,000 neonates met exchange blood transfusion (exchange transfusion [ET]) criteria, while 9/100,000 developed acute bilirubin encephalopathy (ABE), in comparison to results from the only population-based study in Nigeria, in which Olusanya et al. reported 1860/100,000 infants had an EBT.19 Based on the limited data available, ABE is at least as common as tetanus as a cause of neonatal deaths in Nigeria, Kenya, and Pakistan,11,13,2023 and likely in most LMICs often ranking as one of the top five causes of neonatal death.8,11,13,24

Table 13-1. Morbidity and Mortality Associated with Neonatal Jaundice

The available literature indicates that, in LMICs, a significant proportion of survivors of severe neonatal hyperbilirubinemia have signs of chronic bilirubin encephalopathy or kernicterus1 (e.g., cerebral palsy, deafness, and language processing disorders (Table 13-2).2534 Children with disabilities are a tremendous burden on families in LMICs, where resources are already stretched thin; such children are often left with few or no options for improved quality of life35,36 and experience ...

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