While the overall mortality of hemolytic disease of the fetus and newborn (HDFN) has declined in recent years, regional disparities still remain, according to a recent study published in Seminars in Fetal and Neonatal Medicine.
Neonatal deaths disproportionately impact certain areas of the world for a variety of reasons related to access to healthcare, infrastructure, education and finances. Therefore, the authors evaluated several measures of social and economic development to uncover the underlying causes of elevated infant mortality related to hemolytic disorders such as HDFN in these countries.
“As some geographic regions have high incidence of these hemolytic conditions, essential knowledge in populations at risk can help to identify infrastructure and provider skill gaps to target areas for successful interventions,” they wrote.
In their study, the authors analyzed trends in infant mortality due to hemolytic disorders with a particular focus on extreme hyperbilirubinemia (EHB).
Read more about HDFN prognosis
Utilizing the Institute for Health Metrics and Evaluation and Global Burden of Disease joint dataset, the study found that between 1991 and 2021, deaths due to hemolytic and neonatal jaundice decreased by 66% worldwide, with the highest levels observed in countries of South Asia and sub-Saharan Africa.
Next, the authors evaluated the socio-demographic index (SDI), a composite measure of income, years of education and fertility rates. They found that countries with a higher SDI tended to have lower infant mortality rates due to EHB . While countries with a high SDI saw an 86% reduction in mortality, those with a low SDI only saw a 43% decline.
Additionally, countries with limited health care infrastructure saw a 62% reduction in infant mortality due to EHB, while countries with advanced health care systems experienced a 92% reduction.
“Continued local and regional surveillance of healthcare governance is essential to monitor and equitably implement effective, evidence-based interventions across countries to further reduce the life-long global burden of infant mortality due to hemolytic causes,” the authors concluded.
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