Clin Exp Pediatr. 2025 Oct 30. doi: 10.3345/cep.2025.01480. Online ahead of print.
ABSTRACT
BACKGROUND: Although most neonatal disorders are preventable, their global burden has not been comprehensively investigated in the context of underlying epidemiological patterns. Thus, here we conducted the first comprehensive assessment of the global burden of neonatal disorders and their 5 subtypes in 1990-2021 with projections through 2050.
PURPOSE: To comprehensively assess the global burden of neonatal disorders in 1990-2021 and forecast trends through 2050 considering their significant contribution to infant mortality.
METHODS: We estimated the global burden of neonatal disorders (preterm birth, encephalopathy due to birth asphyxia and trauma, hemolytic disease and other neonatal jaundice types, sepsis, and other neonatal infections) and their attributable risk factors, including low birthweight, short gestation, household air pollution, and ambient particulate matter, using data from the Global Burden of Disease Study (GBD) 2021. Population attributable fractions were used to calculate the rates of age-standardized incidence (ASIR), mortality (ASMR), and disability-adjusted life years (ASDR) stratified by age, sex, sociodemographic index (SDI), and region. The disease burden forecasted through 2050 was evaluated by projection modeling using the GBD framework.
RESULTS: From 1990 to 2021, the ASIR, ASMR, and ASDR for neonatal disorders decreased: 466.94 (95% uncertainty interval, 461.65-473.62) to 437.43 (433.20-441.95), 46.06 (43.66- 48.81) to 29.57 (25.37-34.26), and 4,343.25 (4,121.18-4,595.48) to 2,941.00 (2,547.76-3,384.20) per 100,000 population, respectively. Males (489.90 [484.15-495.69]) exhibited a higher rate of the age-standardized incidence for neonatal disorders. The burden of neonatal disorders was markedly higher in countries with lower SDI scores. Neonatal preterm birth is the leading cause of neonatal disorders in both sexes. Among 4 risk factors, a low birthweight contributed the most to the ASDR of neonatal disorders (2,227.54 [1,939.96-2,563.52]). The global ASDR for neonatal disorders is projected to decline from 2,022 (2,317.01 [1,982.04-2,700.43]) to 2,050 (1,230.57 [950.09-1,590.15]).
CONCLUSION: Although the overall burden of neonatal disorders has decreased, substantial disparities have persisted across SDI levels with the highest burden observed in low-SDI countries. Among the subtypes, a preterm neonatal birth accounted for the highest burden, whereas a low birthweight was the most significant risk factor. To achieve global child health targets, it is essential to address regional disparities and promote equity in access to healthcare services and health outcomes.
PMID:41167179 | DOI:10.3345/cep.2025.01480
