ORIGINAL RESEARCH article
Front. Public Health
Sec. Children and Health
This article is part of the Research TopicPublic Health Innovations for Enhancing Newborn and Maternal Well-BeingView all 8 articles
Disease burden and rehabilitation needs of preterm newborns in China from 1990-2021: trend analysis, factor decomposition, attributable risk factors, and projections towards 2035
Provisionally accepted
- 1The First Affiliated Hospital of Lanzhou University, Lanzhou city, China
- 2Pediatric Respiratory Medicine of Zhumadian Central Hospital, Henan, China
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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.
Keywords: Preterm Birth, Rehabilitation needs, disease burden, Risk factors, Decomposition analysis, Global Burden of Disease study
Received: 28 Jul 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Zhu, Fan, Zhang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Mengchen Zhu, zmengchen8@126.com
Shuhua Fan, fanshuhua2311@126.com
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