Global, regional, and national incidence and mortality of neonatal sepsis and other neonatal infections, 1990–2021 and predictions to 2050

Abstract

Background: Neonatal sepsis and other neonatal infections (NSNI) have been long-standing global health challenges, significantly impacting child mortality. This study aims to analyze trends in age-standardized incidence rates (ASIR) and age-standardized mortality rates (ASMR) of NSNI at global, regional, and national levels, and to predict future ASIR trends across different Socio-demographic Index (SDI) regions using ARIMA modeling, to inform strategies for NSNI prevention and treatment. Methods: Data from the 2021 Global Burden of Disease (GBD) study were used to estimate global, regional, and national trends in NSNI-related ASIR and ASMR from 1990 to 2021, and to predict future trends (2022–2050) using the autoregressive integrated moving average (ARIMA) model based on historical data. Results: Between 1990 and 2021, global ASIR and ASMR for NSNI declined at an average annual rate of 0.75%. Cumulatively, ASIR and ASMR decreased by 20.61% and 21.19%, respectively. All five SDI regions experienced declining trends in both ASIR and ASMR, with the greatest annual reduction in ASIR seen in low SDI regions, and the largest reduction in ASMR in high SDI regions. In 2021, Southern Sub-Saharan Africa recorded the highest ASIR (152.22 per 100,000), while Western Sub-Saharan Africa had the highest ASMR (8.55 per 100,000). ARIMA-based predicts indicate that from 2022 to 2050, ASIR is expected to rise in low, low-middle, and high SDI regions. Conclusion: While the global burden of NSNI has decreased in most countries and regions from 1990 to 2021, some areas still exhibit increasing trends. Ongoing epidemiological research and more robust health interventions are crucial to further reducing the global burden of neonatal sepsis.