Journal of Clinical Pediatrics >
International comparison of disease burden of neonatal sepsis (1990-2021) and implications for China
Received date: 2025-03-03
Accepted date: 2025-05-07
Online published: 2025-08-27
Objective Neonatal sepsis (NS) is the third cause of neonatal deaths in the world, with significant differences in disease burden between developing and developed countries. The disease burden of NS in developed and developing countries was compared to provide an evidence-based basis for China to formulate more effective prevention to reduce the disease burden of NS. Methods The NS data of prevalence, incidence, and deaths including number,rate and age standard rate,were extracted from the Global Burden of Diseases 2021 (GBD 2021) database for 1990-2021 in the global, America, China, and India. The Joinpoint regression model was used to analyze the trend, and annual percentage change (APC) and average annual percentage change (AAPC) were calculated. To forecast trends in NS age standard prevalence, incidence, and deaths in the global, America, China, and India from 2021 to 2035. Results As of 2021, the global number of NS prevalence was 9661523, and the number of deaths was 232656. In 2021, compared with 1990, the global age standard prevalence of NS increased by 34.5%,while age standard incidence and deaths respectively decreased 20.6% and 21.2%. From 1990 to 2021, the age standard prevalence, incidence and deaths in India were all higher than the global average. Age standard prevalence in China is increased, while in America it has remained stable. China showed the largest decline in age standard incidence and deaths of NS (35.7% and 65.8%, respectively). Conclusion From 1990 to 2021, the global disease burden of NS showed a downward trend. It is suggested to further optimize the balanced allocation of medical resources to promote the reduction of NS disease burden.
Key words： neonatal sepsis; global burden of diseases; prevalence; incidence; deaths
ZENG Shicheng , FENG Kun , ZHOU Xianlu , HUA Ziyu . International comparison of disease burden of neonatal sepsis (1990-2021) and implications for China[J]. Journal of Clinical Pediatrics, 2025 , 43(9) : 670 -679 . DOI: 10.12372/jcp.2025.25e0179
| [1] | Strunk T, Molloy E J, Mishra A, et al. Neonatal bacterial sepsis[J]. Lancet, 2024, 404(10449): 277-293. |
| [2] | Celik IH, Hanna M, Canpolat FE, et al. Diagnosis of neonatal sepsis: the past, present and future[J]. Pediatr Res, 2022, 91(2): 337-350. |
| [3] | Attia HMH, Parekh R, Dhandibhotla S, et al. Insight Into Neonatal Sepsis: An Overview[J]. Cureus, 2023, 15(9): e45530. |
| [4] | Milton R, Gillespie D, Dyer C, et al. Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study[J]. Lancet Glob Health, 2022, 10(5): e661-e672. |
| [5] | Fang P, Gao K, Yang J, et al. Prevalence of multidrug-resistant pathogens causing neonatal early and late onset sepsis, a retrospective study from the tertiary referral children's hospital[J]. Infect Drug Resist, 2023, 16: 4213-4225. |
| [6] | Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021[J]. Lancet, 2024, 403(10440): 2133-2161. |
| [7] | Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021[J]. Lancet, 2024, 403(10440): 2162-2203. |
| [8] | Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021[J]. Lancet, 2024, 403(10440): 1989-2056. |
| [9] | Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates[J]. Stat Med, 2000, 19(3): 335-351. |
| [10] | Wang X, Xiu R, Gong L, et al. Unraveling the global burden of inflammatory bowel disease (1990-2019): A Joinpoint regression analysis of divergent trends in 10-24 and 50-69 age cohorts[J]. Autoimmun Rev, 2024, 23(6): 103586. |
| [11] | Riebler A, Held L. Projecting the future burden of cancer: Bayesian age-period-cohort analysis with integrated nested Laplace approximations[J]. Biom J, 2017, 59(3): 531-549. |
| [12] | Cao G, Liu J, Liu M. Global, regional, and national incidence and mortality of neonatal preterm birth, 1990-2019[J]. JAMA Pediatr, 2022, 176(8): 787-796. |
| [13] | Ryan L, Pl?tz FB, van den Hoogen A, et al. Neonates and COVID-19: state of the art : Neonatal Sepsis series[J]. Pediatr Res, 2022, 91(2): 432-439. |
| [14] | Guo L, Han W, Su Y, et al. Perinatal risk factors for neonatal early-onset sepsis: a meta-analysis of observational studies[J]. J Matern Fetal Neonatal Med, 2023, 36(2): 2259049. |
| [15] | Benitz WE, Achten NB. Technical assessment of the neonatal early-onset sepsis risk calculator[J]. Lancet Infect Dis, 2021, 21(5): e134-e140. |
| [16] | Achten NB, Klingenberg C, Benitz WE, et al. Association of use of the neonatal early-onset sepsis calculator with reduction in antibiotic therapy and safety: a systematic review and meta-analysis[J]. JAMA Pediatr, 2019, 173(11): 1032-1040. |
| [17] | Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion, Number 797[J]. Obstet Gynecol, 2020, 135(2): e51-e72. |
| [18] | Giannoni E, Dimopoulou V, Klingenberg C, et al. Analysis of antibiotic exposure and early-onset neonatal sepsis in Europe, North America, and Australia[J]. JAMA Netw Open, 2022, 5(11): e2243691. |
| [19] | Yu Y, Dong Q, Li S, et al. Etiology and clinical characteristics of neonatal sepsis in different medical setting models: A retrospective multi-center study[J]. Front Pediatr, 2022, 10: 1004750. |
| [20] | Qiu Y, Yang J, Chen Y, et al. Microbiological profiles and antimicrobial resistance patterns of pediatric bloodstream pathogens in China, 2016-2018[J]. Eur J Clin Microbiol Infect Dis, 2021, 40(4): 739-749. |
| [21] | Dudeja S. Neonatal Sepsis: Treatment of neonatal sepsis in multidrug-resistant (MDR) infections: Part 2[J]. Indian J Pediatr, 2020, 87(2): 122-124. |
| [22] | Correction: Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network[J]. Arch Dis Child, 2020, 105(5): 519. |
| [23] | Popescu CR, Cavanagh M, Tembo B, et al. Neonatal sepsis in low-income countries: epidemiology, diagnosis and prevention[J]. Expert Rev Anti Infect Ther, 2020, 18(5): 443-452. |
| [24] | Batthula V, Somnath SH, Datta V. Reducing late-onset neonatal sepsis in very low birthweight neonates with central lines in a low-and-middle-income country setting[J]. BMJ Open Qual, 2021, 10(Suppl 1): e001353. |
| [25] | Zhang HX, Zhao YY, Wang YQ. Analysis of the characteristics of pregnancy and delivery before and after implementation of the two-child policy[J]. Chin Med J (Engl), 2018, 131(1): 37-42. |
| [26] | Ma Y, Hu M, Zafar Q. Analysis of the impact of external debt on health in an emerging Asian economy: Does FDI matter?[J]. Front Public Health, 2022, 10: 824073. |
| [27] | Bang A, Deshmukh M, Baitule S, et al. Decline in the incidence of neonatal sepsis in rural gadchiroli, india during the twenty-one years (1998-2019) following the home-based neonatal care field-trial[J]. Pediatr Infect Dis J, 2021, 40(11): 1029-1033. |
| [28] | Bang A, Baitule S, Deshmukh M, et al. Home-based management of neonatal sepsis: 23 years of sustained implementation and effectiveness in rural Gadchiroli, India, 1996-2019[J]. BMJ Glob Health, 2022, 7(9): e008469. |
| [29] | Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021[J]. Lancet, 2024, 403(10440): 2100-2132. |
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