Objective  To analyze the disease burden and its trend of neonatal encephalopathy due to birth asphyxia and trauma in China from 1990 to 2019.

Methods  From the Global Burden of Disease Study 2019, data about disability-adjusted life years (DALYs), DALY rates, mortality, mortality rates and risk factors for neonatal encephalopathy due to birth asphyxia and trauma in China from 1990 to 2019 were extracted. The Joinpoint regression analysis was employed to calculate the annual average percentage change (AAPC) and 95% confidence intervals (CI) of mortality rate and DALY rate.

Results  In 2019, the mortality rate for neonatal encephalopathy due to birth asphyxia and trauma in China was 1 139.527 people per 100 000, and the DALY rate was 101 275.239 person years per 100 000, both of which had decreased by 76.23% compared to 1990. Among which, the mortality rates for male and female neonates were 1  230.738 people per 100 000 and 1 033.004 people per 100 000, respectively, and DALY rates were 109 381.824 person years per 100 000 and 91 807.766 person years per 100 000, respectively; the mortality rates for neonates aged 0 to 6 days and 7 to 28 days were 4 022.626 people per 100 000 and 178.166 people per 100 000, respectively, and DALY rates were 357 481.444 person years per 100 000 and 15 844.063 person years per 100 000, respectively. The AAPC for mortality rate and DALY rate from 1990 to 2019 was both -4.88 [95% CI(-5.17, -4.59)]. Small than gestational age, premature birth, environmental particulate pollutants, and household pollution from solid fuel combustion were the main risk factors for neonatal encephalopathy caused by birth asphyxia and trauma in China.

Conclusion  Compared to 1990, the mortality rate and DALY rate for neonatal encephalopathy due to birth asphyxia and trauma in China in 2019 showed a declining trend. The disease burden for male children in the early neonatal period was higher than that for female children. Policies should be formulated to address factors such as being small gestational age, preterm birth, ambient particulate matter pollution, and household pollution from the burning of solid fuels, and to continue to focus on prenatal care services, with the aim of reducing the disease burden of neonatal encephalopathy due to birth asphyxia and trauma.

1.黄秀清, 程国强. 新生儿脑病: 多病因识别[J]. 中国小儿急救医学, 2021, 28(8): 649-653. [Huang XQ, Cheng GQ. Neonatal encephalopathy: identification of multiple causes[J]. Chinese Pediatric Emergency Medicine, 2021, 28(8): 649-653.] DOI: 10.3760/cma.j.issn.1673-4912.2021.08.002.

2.Iribarren I, Hilario E, Álvarez A, et al. Neonatal multiple organ failure after perinatal asphyxia[J]. An Pediatr（Engl Ed), 2022, 97(4): 280.e1-280.e8. DOI: 10.1016/j.anpede.2022.08.010.

3.Ding C, Wu Y, Chen X, et al. Global, regional, and national burden and attributable risk factors of neurological disorders: the Global Burden of Disease study 1990—2019[J]. Front Public Health, 2022, 10: 952161. DOI: 10.3389/fpubh.2022.952161.

4.GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990—2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1223-1249. DOI: 10.1016/S0140-6736(20)30752-2.

5.Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990—2017: a systematic analysis for the global burden of disease study 2017[J]. Lancet, 2019, 394(10204): 1145-1158. DOI: 10.1016/S0140-6736(19)30427-1.

6.师维, 崔旋旋, 周伍明, 等. 1990—2019年中国心肌炎疾病负担水平及其变化分析[J]. 医学新知, 2023, 33(5): 325-333. [Shi W, Cui XX, Zhou WM, et al. Analysis of the change in disease burden of myocarditis in China from 1990 to 2019[J]. Yixue Xinzhi Zazhi, 2023, 33(5): 325-333.] DOI: 10.12173/j.issn.1004-5511.202211067.

7.李辉章, 杜灵彬. Joinpoint回归模型在肿瘤流行病学时间趋势分析中的应用[J]. 中华预防医学杂志, 2020, 54(8): 908-912. [Li HZ, Du LB, et al. Application of Joinpoint regression model in cancer epidemiological time trend analysis[J]. Chinese Journal of Preventive Medicine, 2020, 54(8): 908-912.] DOI: 10.3760/cma.j.cn112150-20200616-00889.

8.国家卫生健康委妇幼健康司. 中国妇幼健康事业发展报告(2019) [EB/OL].（2019-05-27) [2024-07-21]. http://www.nhc.gov.cn/fys/s7901/201905/bbd8e2134a7e47958c5c9ef032e1dfa2.shtml.

9.De Angelis LC, Brigati G, Polleri G, et al. Neonatal hypoglycemia and brain vulnerability[J]. Front Endocrinol (Lausanne). 2021, 12: 634305. DOI: 10.3389/fendo.2021. 634305.

10.Tesfay N, Tariku R, Zenebe A, et al. Cause and risk factors of early neonatal death in Ethiopia[J]. PLoS One, 2022, 17(9): e0275475. DOI: 10.1371/journal.pone.0275475.

11.Mallard C, Tremblay ME, Vexler ZS. Microglia and neonatal brain injury[J]. Neuroscience, 2019, 405: 68-76.DOI: 10.1016/j.neuroscience.2018.01.023.

12.Kelly LA, Branagan A, Semova G, et al Sex differences in neonatal brain injury and inflammation[J]. Front Immunol, 2023, 14: 1243364. DOI: 10.3389/fimmu.2023.1243364.

13.Migliori C, Braga M, Siragusa V, et al. The impact of gender medicine on neonatology: the disadvantage of being male: a narrative review[J]. Ital J Pediatr, 2023, 49(1): 65. DOI: 10.1186/s13052-023-01447-2.

14.Zheng Q, Freeman CW, Hwang M. Sex-related differences in arterial spin-labelled perfusion of metabolically active brain structures in neonatal hypoxic-ischaemic encephalopathy[J]. Clin Radiol, 2021, 76(5): 342-347. DOI: 10.1016/j.crad.2020.12.026.

15.Stavsky M, Mor O, Mastrolia SA, et al. Cerebral palsy-trends in epidemiology and recent development in prenatal mechanisms of disease, treatment, and prevention[J]. Front Pediatr, 2017, 5: 21. DOI: 10.3389/fped.2017.00021.

16.中国医师协会新生儿科医师分会循证专业委员会. 早产儿和低出生体重儿袋鼠式护理临床实践指南(2022)[J]. 中国循证医学杂志, 2023, 23(3): 249-264. [Evidence-Based Medicine Group, Neonatologist Society, Chinese Medical Doctor Association. Clinical practice guidelines for kangaroo mother care in preterm and low birth weight infants (2022)[J]. Chinese Journal of Evidence-Based Medicine, 2023, 23(3): 249-264.] DOI: 10.7507/1672-2531.202209145.

17.刘十羽, 高笑宇, 孙德俊. 固体燃料导致的室内空气污染对肺部疾病的作用[J]. 国际呼吸杂志, 2021, 41(15): 1195-1200. [Liu SY, Gao XY, Sun DJ. Effect of indoor air pollution caused by solid fuel on pulmonary diseases[J]. International Journal of Respiration, 2021, 41(15): 1195-1200.] DOI: 10.3760/cma.j.cn131368-20200817-00732.

18.Tang Z, Jia J. PM2.5-related neonatal encephalopathy due to birth asphyxia and trauma: a global burden study from 1990 to 2019[J]. Environ Sci Pollut Res Int, 2023, 30(12): 33002-33017. DOI: 10.1007/s11356-022-24410-w.