Abstract
Background: Air pollution exposure is an environmental risk to public health. And the available data on relationships of air pollution and neonatal disease burden are scarce. This study assessed neonatal disease burden attributable to Particulate Matter 2.5 (PM 2.5) pollution in China.Methods: This is a retrospective analysis with data from the GBD2019 database. Data of PM 2.5 pollution exposure levels and neonatal disease burden attributable to PM 2.5 in China from 1990 to 2019 were obtained from the Global Burden of Disease Study 2019 (GBD 2019); Data of PM2.5 concentration was collected from the Bulletin of the State of the Ecological Environment in China; Data of perinatal mortality was collected from the Chinese Maternal and Child Health Surveillance Network. Deaths, Disability-adjusted life years (DALYs), Year of life lost (YLLs), and Years lived with disability (YLDs) are primary indicators used to assess neonatal diseases burden. The correlation of PM2.5 pollution and neonatal death was analyzed. Average Annual Percentage Change (AAPC) and increment were used to assess exposure levels and disease burden trends.Results: PM 2.5 pollution exposure level of newborns in China is much higher than global average, 32.08 per 100 people (95% UI: 26.57–38.06) in 2019 compared to 1990 (15.86 per 100 people, 95% UI: 6.83–30.88), with an increase of 102.27%. And it is statistically verified PM2.5 concentration was positively correlated with neonatal disease deaths (r = 0.9534, p = 0.0009) and DALYs (r = 0.9534, p = 0.0009). The overall disease burden of neonatal diseases attributed to PM 2.5 pollution in China has decreased from 1990 to 2019, with a decrement of 5738.34 deaths (decreased: 56.85%), 51.01 person/years (decreased: 56.84%) for DALYs, 51.23 person/years (decreased: 57.11%) for YLLs and an increase of 150.69 person/years (increased: 31.71%) for YLDs.Conclusion: There exists positive correlation between environmental pollution and neonatal diseases in China. The number of neonatal disease deaths, DALYs, and YLLs due to PM 2.5 pollution showed a decreasing trend with the environmental pollution control. For the rising YLDs, there is a need to improve survival rates while focusing on prognosis of neonatal disease and reducing the burden of disease brought on by disability. Controlling environmental pollution is likely to help reduce neonatal disease burden, especially premature birth and neonatal encephalopathy.
Highlights
Newborns’ first 28 days of life are the most vulnerable period for a child’s survival, with approximately 2.5 million children dying each year in the first month of life (EF et al, 2017)
The years lived with disability (YLDs) due to disease-induced disability was estimated by multiplying the disease prevalence with different disability weights, and the disability-adjusted life years (DALYs) was obtained by summing YLD and years of life lost (YLLs) (Liu et al, 2019)
This study assessed neonatal disease burden of attributable to PM 2.5 pollution in China from 1990 to 2019 using data related to PM 2.5 pollution exposure and neonatal disease obtained from the Global Burden of Disease (GBD) research
Summary
Newborns’ first 28 days of life (neonatal period) are the most vulnerable period for a child’s survival, with approximately 2.5 million children dying each year in the first month of life (EF et al, 2017). Newborns may suffer from various diseases in this stage, such as prematurity, neonatal encephalopathy, jaundice, and sepsis. The global neonatal mortality rate decreased from 3.66% in 1990 to 1.80% in 2017, with China decreasing from 2.95% in 1990 to 0.47% in 2017. In the United States, the neonatal mortality rate decreased from 0.58% in 1990 to 0.36% in 2017, while in Japan, it decreased from 0.25% in 1990 to 0.09% in 2017. In 2017, neonatal diseases were ranked ninth in the YLL ranking of the 25 leading causes of death of newborns in China (Zhou et al, 2019). The available data on relationships of air pollution and neonatal disease burden are scarce. This study assessed neonatal disease burden attributable to Particulate Matter 2.5 (PM 2.5) pollution in China
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