Disease burden of neonatal diseases in China in 1990 and 2019: a comparison analysis
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摘要:
目的 比较中国1990年与2019年新生儿疾病的疾病负担,为新生儿疾病的预防控制提供参考依据。 方法 收集2019年全球疾病负担研究(GBD 2019)中1990年和2019年中国新生儿疾病负担的相关数据,采用患病数、标化患病率、死亡数、标化死亡率、过早死亡损失寿命年(YLLs)、标化YLLs率、伤残损失健康寿命年(YLDs)、标化YLDs率、伤残调整寿命年(DALYs)和标化DALYs率和年估计变化百分比(EAPC)等指标分析中国1990年与2019年新生儿疾病负担的变化情况。 结果 2019年与1990年比较,中国新生儿疾病的患病数和标化患病率均呈上升趋势,EAPC分别为2.83%(95%UI = 2.59%~3.07%)和2.52%(95%UI = 2.33%~2.72%);而死亡数和标化死亡率均呈下降趋势, EAPC分别为 – 6.40%(95%UI = – 6.64%~– 6.16%)和 – 5.10%(95%UI = – 5.59%~– 4.62%);YLDs和标化YLDs率上升,EAPC分别为4.05%(95%UI = 3.88%~4.21%)和3.86%(95%UI = 3.68%~4.04%);而YLLs、标化YLLs率、DALYs和标化DALYs率下降,EAPC分别为 – 6.40%(95%UI = – 6.16%~ – 6.64%)、– 5.11%(95%UI = – 4.62%~– 5.59%)、– 4.75%(95%UI = – 4.48%~– 5.02%)和 – 4.09%(95%UI = – 3.74%~– 4.45%)。2019年中国新生儿疾病标化患病率、标化死亡率、标化YLLs率和标化DALYs率最高的均为新生儿早产,标化YLDs率最高的为新生儿脓毒症及其他新生儿感染。 结论 2019年与1990年比较,中国新生儿疾病的患病率和YLDs率上升,新生儿健康问题不容忽视,应落实新生儿保健的相关管理措施,对新生儿疾病早发现、早治疗,进一步降低新生儿疾病负担。 Abstract: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. -
Key words:
- neonatal disease /
- disease burden /
- comparison
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表 1 中国1990年与2019年各类新生儿疾病患病情况比较
新生儿疾病 1990 年 2019 年 EAPC 95%UI 患病数
(万例)95%UI 标化患病率
(1/10万)95%UI 患病数
(万例)95%UI 标化患病率
(1/10万)95%UI 新生儿早产 630.35 554.15~707.98 527.17 463.59~591.84 816.48 723.89~919.28 642.09 575.42~717.54 0.75 0.66~0.85 出生时窒息或外伤
导致的新生儿脑病25.46 10.28~53.71 20.79 8.52~43.40 59.84 42.87~80.40 44.75 31.94~60.30 3.20 3.04~3.37 新生儿脓毒症及其他
新生儿感染166.49 116.94~227.06 138.40 97.77~188.25 713.59 539.19~933.82 528.56 400.06~690.15 5.57 5.29~5.85 溶血性疾病及其他
新生儿黄疸9.79 8.53~11.19 7.99 6.96~9.13 16.35 14.62~18.16 12.24 10.94~13.58 1.67 1.58~1.77 表 2 中国1990年与2019年各类新生儿疾病死亡情况比较
新生儿疾病 1990 年 2019 年 EAPC 95%UI 死亡数
(万例)95%UI 标化死亡率
(1/10万)95%UI 死亡数
(万例)95%UI 标化死亡率
(1/10万)95%UI 新生儿早产 15.73 13.77~17.82 13.63 11.94~15.44 2.21 1.89~2.57 3.07 2.62~3.56 − 5.36 − 5.64~− 5.09 出生时窒息或外伤
导致的新生儿脑病9.36 8.20~10.89 8.11 7.11~9.45 1.45 1.23~1.71 2.01 1.71~2.37 − 5.48 − 6.42~− 4.52 新生儿脓毒症及其他
新生儿感染0.48 0.38~0.56 0.42 0.33~0.49 0.19 0.16~0.23 0.26 0.22~0.31 − 1.91 − 2.10~− 1.71 溶血性疾病及其他
新生儿黄疸0.88 0.73~1.04 0.76 0.63~0.90 0.10 0.08~0.11 0.13 0.11~0.16 − 6.27 − 6.61~− 5.92 其他新生儿疾病 2.14 1.86~2.44 1.86 1.61~2.11 0.54 0.44~0.65 0.74 0.60~0.89 − 2.64 − 3.20~− 2.06 表 3 中国1990年与2019年各类新生儿疾病YLLs情况比较
新生儿疾病 1990 年 2019 年 EAPC 95%UI YLLs
(万人年)95%UI 标化YLLs率
(1/10万)95%UI YLLs
(万人年)95%UI 标化YLLs率
(1/10万)95%UI 新生儿早产 1396.11 1222.82~1581.51 1209.71 1059.62~1370.22 196.51 167.99~228.38 272.40 232.94~316.37 − 5.36 − 5.64~− 5.09 出生时窒息或外伤
导致的新生儿脑病831.06 728.29~967.63 720.61 631.50~839.19 128.90 109.26~151.53 178.65 151.33~209.96 − 5.48 − 6.42~− 4.53 新生儿脓毒症及其他
新生儿感染42.61 33.67~50.02 36.90 29.16~43.32 17.04 14.18~20.06 23.45 19.49~27.61 − 1.91 − 2.11~− 1.72 溶血性疾病及其他
新生儿黄疸78.13 64.89~92.50 67.62 56.17~80.04 8.43 6.95~10.06 11.55 9.51~13.80 − 6.27 − 6.61~− 5.92 其他新生儿感染 190.01 164.81~216.19 164.53 142.74~187.16 48.05 38.85~57.71 65.91 53.33~79.10 − 2.64 − 3.21~− 2.07 表 5 中国1990年与2019年各类新生儿疾病DALYs情况比较
新生儿疾病 1990 年 2019 年 EAPC 95%UI DALYs
(万人年)95%UI 标化DALYs率
(1/10万)95%UI DALYs
(万人年)95%UI 标化DALYs率
(1/10万)95%UI 新生儿早产 1468.85 1291.63~165358 1268.71 1115.93~1429.65 308.82 272.10~350.88 357.69 313.97~406.91 − 4.64 − 4.86~− 4.42 出生时窒息或外伤
导致的新生儿脑病840.51 738.60~976.66 728.28 640.09~845.73 147.38 126.14~171.53 192.54 164.00~225.52 − 5.27 − 6.18~− 4.35 新生儿脓毒症及其他
新生儿感染61.78 46.64~84.17 52.48 39.88~70.48 174.96 122.19~240.75 140.53 100.90~190.22 4.02 3.80~4.24 溶血性疾病及其他
新生儿黄疸82.41 68.75~97.11 71.11 59.33~83.79 14.48 12.39~16.75 16.09 13.77~18.59 − 5.39 − 5.66~− 5.12 其他新生儿疾病 195.44 170.01~221.85 169.20 147.17~192.07 56.11 46.90~65.97 75.74 63.15~89.17 − 2.30 − 2.82~− 1.78 表 4 中国1990年与2019年各类新生儿疾病YLDs情况比较
新生儿疾病 1990 年 2019 年 EAPC 95%UI YLDs
(万人年)95%UI 标化YLDs率
(1/10万)95%UI YLDs
(万人年)95%UI 标化YLD率
(1/10万)95%UI 新生儿早产 72.74 54.90~93.78 59.00 44.65~76.24 112.31 87.34~140.40 85.29 66.46~106.36 1.52 1.39~1.64 出生时窒息或外伤
导致的新生儿脑病9.45 2.62~23.42 7.68 2.16~18.99 18.48 11.27~27.78 13.89 8.53~20.85 2.48 2.31~2.66 新生儿脓毒症及其他
新生儿感染19.17 7.56~41.64 15.58 6.20~33.88 157.92 104.51~223.27 117.08 77.28~166.32 8.27 7.84~8.69 溶血性疾病及其他
新生儿黄疸4.28 3.21~5.43 3.49 2.62~4.43 6.05 4.57~7.62 4.54 3.44~5.70 1.05 0.92~1.17 其他新生儿感染 5.43 4.03~7.09 4.68 3.47~6.11 8.06 6.05~10.35 9.83 7.36~12.62 3.00 2.84~3.16 -
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