ArticleFrontiers in public health2026
Global, regional, and national burden of preterm birth 1990 to 2023, with projections of prevalence to 2050.
Article in Frontiers in public health, 2026. 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
Background: Preterm birth, the leading cause of under-five mortality, resulted in approximately 0.6 million neonatal deaths in 2023 and significant lifelong morbidity for survivors, including neurodevelopmental and respiratory impairments. This study aims to provide an updated assessment of age-standardized rates (ASR) in preterm birth prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2023. Comprehensive, updated estimates are vital to guide resource allocation to neonatal intensive care units (NICUs), target maternal health interventions, and inform national prevention policies. Methods: Using data from the Global Burden of Disease 2023, we analyzed the global, regional, and national burden of preterm birth from 1990 to 2023, extracted estimating prevalence, incidence, deaths, DALYs, and age-standardized rates. Trends were assessed via estimated annual percentage change (EAPC), with data stratified by age, sex, location, Socio-demographic Index (SDI). Analyses were performed using R software (Version 4.5.0). Results: In 2023, there were 125.5 million global cases of preterm birth, representing a 53.9% increase since 1990. The age-standardized prevalence rate (ASPR) increased slightly (EAPC: 0.40; 95% CI: 0.38-0.42) and age-standardized incidence rate (ASIR) decreasing (EAPC: -0.33; 95% CI: -0.40 to -0.27), suggesting the tremendous success of global neonatal healthcare over the past few decades. Despite these improvements, 623,303 deaths and 70.2 million DALYs were attributed to preterm birth in 2023, with age-standardized death rate (ASDR) and DALY rates decreasing (EAPCs: -2.39 and -2.03, respectively). The highest burden was observed in South Asia and Sub-Saharan Africa, which collectively exceeding 11 per 100,000 population of ASDRs particularly in low- and low-middle SDI regions. Looking ahead, projections based on historical trends and sociodemographic forecasts suggest that while absolute prevalence is expected to rise slightly by 2050, mortality and DALY rates will continue to decline. Conclusions: The global burden of preterm birth presents a dual challenge: while age-standardized deaths and DALY rates are declining, the absolute number of prevalence continues to rise, driven by population growth. To meet Sustainable Development Goals requires a dual-pronged strategy: strengthening neonatal intensive care in high-burden regions and advancing maternal health equity through preventative interventions.
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