Objective  To explore changing trend of disease burden of neonatal diseases in China from 1990 to 2019 and to provide evidence for prevention and treatment of neonatal diseases.

  Methods  The data on neonatal diseases in China for years of 1990 and 2019 were extracted from the Global Burden of Disease Study 2019 (GBD 2019). The number of patients, standardized prevalence, mortality, standardized mortality, years of life lost (YLLs), standardized YLLs, years lived with disability (YLDs), standardized YLDs, disability adjusted life years (DALYs), standardized DALYs, and estimated annual percent change (EAPC) were adopted to evaluate variations in disease burden of neonatal diseases between 1990 and 2019.

  Results  Compared with those in 1990, both the number of patients and standardized prevalence rate of neonatal diseases in China increased, with the EAPC of 2.83% (95% uncertainty interval UI: 2.59%, 3.07%) and 2.52% (95%UI: 2.33%, 2.72%); while the mortality and standardized mortality rates were both on the decline, with the EAPC of − 6.40% (95%UI: − 6.64%, − 6.16%) and − 5.10% (95%UI: − 5.59%, − 4.62%), respectively. The neonatal diseases-related YLDs and standardized YLDs rate increased, with the EAPC of 4.05% (95%UI: 3.88%, 4.21%) and 3.86% (95%UI: 3.68%, 4.04%); but the YLLs, standardized YLLs rate, the DALYs, and standardized DALYs rate decreased, with the EAPC of − 6.40% (95%UI: − 6.16%, − 6.64 %), − 5.11% (95%UI: − 4.62%, − 5.59%), − 4.75% (95%UI: − 4.48%, − 5.02%), and − 4.09% (95%UI: − 3.74%, − 4.45%). Among the neonatal diseases, preterm birth was the leading category as ranked by standardized rate of prevalence, mortality, YLLs, and DALYs; nonspecific neonatal infections was the leading category as ranked by standardized YLDs.

  Conclusion  The prevalence and YLDs rate of neonatal diseases in China increased in 2019 compared with those in 1990. Early diagnosis and treatment of neonatal diseases should be improved to reduce the burden caused by the diseases.