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Original Article

Global and regional burden of neonatal disorders (preterm birth, encephalopathy, jaundice, and sepsis), 1990–2021 and projections to 2050

Yuseon Kang^1,2  , Jeongseon Oh^2,3  , Dongjin Yeo^1,2  , Jaeyu Park^2,3  , Sooji Lee^1,2  , Na Yun Kim^1,2  , Jungmin Park^1,2  , Seung Ha Hwang^2,4  , Tae Hyeong Kim⁶  , Dong Keon Yon¹ 

¹Department of Medicine, Kyung Hee University College of Medicine, Seoul, Korea
²Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea
³Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Korea
⁴Department of Biomedical Engineering, Kyung Hee University, Yongin, Korea
⁵Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, Korea
⁶Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
⁷Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea

Correspondence Dong Keon Yon ,Email: yonkkang@gmail.com

Received: June 30, 2025; Revised: August 11, 2025   Accepted: September 3, 2025.

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.

Keywords :Disability-adjusted life years, Global Burden of Disease, Incidence, Newborn infant, Mortality