Biliary atresia occurs in approximately 1 in 18,000 live births in Western Europe.[10]Chardot C. Biliary atresia. Orphanet J Rare Dis. 2006;1:28.
http://ojrd.biomedcentral.com/articles/10.1186/1750-1172-1-28
In the world, the reported incidence varies from 5 to 32 cases per 100,000 live births, and is highest in Asia and the Pacific region. Females are affected slightly more often than males.[10]Chardot C. Biliary atresia. Orphanet J Rare Dis. 2006;1:28.
http://ojrd.biomedcentral.com/articles/10.1186/1750-1172-1-28
Estimates of the incidence of biliary atresia in Taiwan and Japan range from 1.1 to 3.7 cases per 10,000 live births.[11]Wang SH, Chen CL, Concejero A, et al. Living donor liver transplantation for biliary atresia. Chang Gung Med J. 2007;30:103-108.
http://www.ncbi.nlm.nih.gov/pubmed/17595997?tool=bestpractice.com
[12]Wada H, Muraji T, Yokoi A, et al. Insignificant seasonal and geographical variation in incidence of biliary atresia in Japan: a regional survey of over 20 years. J Ped Surg. 2007;42:2090-2092.
http://www.ncbi.nlm.nih.gov/pubmed/18082714?tool=bestpractice.com
[13]Tiao MM, Tsai SS, Kuo HW, et al. Epidemiological features of biliary atresia in Taiwan, a national study 1996-2003. J Gastroent Hepatol. 2008;23:62-66.
http://www.ncbi.nlm.nih.gov/pubmed/17725591?tool=bestpractice.com
In the US, biliary atresia occurs with an estimated frequency of 1 in 8000 to 15,000 live births, resulting in 250 to 400 new cases per year.[14]Schreiber RA, Kleinman RE. Genetics, immunology, and biliary atresia: an opening or a diversion? J Pediatr Gastroenterol Nutr. 1993;16:111-113.
http://www.ncbi.nlm.nih.gov/pubmed/8450373?tool=bestpractice.com
[15]Cavallo L, Kovar EM, Aqul A, et al. The epidemiology of biliary atresia: exploring the role of developmental factors on birth prevalence. J Pediatr. 2022 Jul;246:89-94.e2.
https://www.jpeds.com/article/S0022-3476(22)00288-8/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35364097?tool=bestpractice.com
The highest incidence has been reported in French Polynesia (1:3500).[16]Schreiber RA, Harpavat S, Hulscher JBF, et al. Biliary atresia in 2021: epidemiology, screening and public policy. J Clin Med. 2022 Feb 14;11(4):999.
https://www.mdpi.com/2077-0383/11/4/999
http://www.ncbi.nlm.nih.gov/pubmed/35207269?tool=bestpractice.com
It is the most common cause of neonatal jaundice requiring surgical intervention and the most common indication for liver transplantation in children.[17]Yoon PW, Bresee JS, Olney RS, et al. Epidemiology of biliary atresia: a population-based study. Pediatrics. 1997;99:376-382.
http://www.ncbi.nlm.nih.gov/pubmed/9041292?tool=bestpractice.com
There is increased incidence among African-Americans.[18]Sokol RJ, Mack C, Narkewicz MR, et al. Pathogenesis and outcome of biliary atresia: current concepts. J Pediatr Gastroenterol Nutr. 2003;37:4-21.
http://www.ncbi.nlm.nih.gov/pubmed/12827000?tool=bestpractice.com
Seasonal clustering has been reported that varies between regions and states.[16]Schreiber RA, Harpavat S, Hulscher JBF, et al. Biliary atresia in 2021: epidemiology, screening and public policy. J Clin Med. 2022 Feb 14;11(4):999.
https://www.mdpi.com/2077-0383/11/4/999
http://www.ncbi.nlm.nih.gov/pubmed/35207269?tool=bestpractice.com
[19]Ayas MF, Hillemeier AC, Olson AD. Lack of evidence for seasonal variation in extrahepatic biliary atresia during infancy. J Clin Gastroenterol. 1996;22:292-294.
http://www.ncbi.nlm.nih.gov/pubmed/8771425?tool=bestpractice.com
[20]Caton AR, Druschel CM, McNutt LA. The epidemiology of extrahepatic biliary atresia in New York State, 1983-98. Paediatr Perinat Epidemiol. 2004;18:97-105.
http://www.ncbi.nlm.nih.gov/pubmed/14996248?tool=bestpractice.com
A possible genetic component remains elusive; identical twins are not similarly affected, yet there have been several isolated case reports of multiple first-degree relatives, including twins, being affected.[21]Smith BM, Laberge JM, Schreiber R, et al. Familial biliary atresia in three siblings including twins. J Pediatr Surg. 1991;26:1331-1333.
http://www.ncbi.nlm.nih.gov/pubmed/1812269?tool=bestpractice.com