Comparison of disease burden and major risk factors of early and late-onset neonatal sepsis in China and the USA, 1990-2019

Background: Neonatal sepsis has high morbidity and mortality, and there are differences between developing and developed countries in terms of its risk factors and disease burden. However, no systematic comparative analysis of this disease burden has been reported in recent years. Methods: : Using the Global Burden of Disease Study (GBD) 2019 as a data source, we assessed the prevalence, incidence, and disability-adjusted life years (DALYs) of early and late-onset neonatal sepsis in China and the United States of America (USA). We also analyzed DALYs rates due to short gestation and low birthweight, and summary exposure value (SEV) for these two risk factors. Joinpoint regression models were applied to analyze the temporal trends in associated epidemiological indicators of neonatal sepsis. Results: : From 1990 to 2019, the incidence and prevalence of neonatal sepsis in China showed a significant upwards trend compared with the largely stable trend in the USA. DALYs due to short gestation and low birthweight for neonatal sepsis in both genders showed a decreasing trend in both countries, while years lived with disability (YLDs) in China showed a fluctuating increasing trend. Conclusions: : DALYs attributed to short gestation and low birth-weight for neonatal sepsis in both countries showed a decreasing trend, while the YLDs and SEVs of these two risks are on the rise in China. Therefore, Chinese public health policy needs to be geared towards controlling these risk factors, learning from the advanced health policy planning and perinatal management experiences of developed countries, and improving neonatal follow-up and rehabilitation interventions.