ArticleFrontiers in public health2025
Disease burden and rehabilitation needs of preterm newborns in China from 1990 to 2021: trend analysis, factor decomposition, attributable risk factors, and projections toward 2035.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To analyze trends, risk factors, and project future trajectories of rehabilitation needs and disease burden in preterm newborns in China (1990-2035). Methods: Using GBD 2021 data, we assessed preterm birth burden via age-standardized prevalence rate (ASPR) and age-standardized years lived with disability rate (ASYR). Joinpoint regression calculated annual percentage changes (APC, AAPC) and estimated annual percentage changes (EAPC). Decomposition analysis quantified contributions of aging, population growth, and epidemiological changes to YLDs. Risk factor attribution was assessed for low birth weight, short gestation, ambient particulate matter pollution, and household air pollution from solid fuels. An ARIMA model projected trends to 2035. Results: ASPR declined significantly from 812.7/100,000 (95% CI: 702.2-931.2) in 1990 to 645.4/100,000 (95% CI: 572.5-728.1) in 2021 (EAPC = -1.1, 95% CI: -1.3 to -0.9). ASYR decreased from 67.4/100,000 (95% CI: 48.1-89.1) to 63.1/100,000 (95% CI 45.2-80.7) (EAPC = -0.5, 95% CI: -0.6 to -0.5). Males exhibited higher ASPR and ASYR than females. Low birth weight and short gestation were predominant risk factors (e.g., ASYR attributable to low birth weight: 67.43/100,000 in 1990, 63.06/100,000 in 2021). Decomposition showed epidemiological changes (-707,840.1% for low birth weight/short gestation) and population growth (718,149.34%) drove YLD changes. Projections estimate preterm births decreasing from 7,887,971 (2022) to 7,568,882 (2035), with ASPR falling to 506.88/100,000 and ASYR potentially rising slightly to 60.45/100,000 by 2035. Conclusion: While preterm birth burden in China has decreased since 1990, a significant burden persists, disproportionately affecting males. Low birth weight and short gestation are key modifiable risks. Projected trends underscore the need for enhanced public health interventions targeting identified risk factors and strengthening continuum-of-care rehabilitation services to further reduce burden and improve outcomes.
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