1990-2019年中国出生窒息/创伤所致新生儿脑病疾病负担分析

Analysis of the disease burden of neonatal encephalopathy due to birth asphyxia and trauma in China from 1990 to 2019

目的分析1990—2019年我国出生窒息/创伤所致新生儿脑病的疾病负担水平及其变化趋势。方法从2019年全球疾病负担研究数据库中提取1990—2019年我国出生窒息/创伤所致新生儿脑病的伤残调整寿命年(disability-adjusted life years,DALY)、DALY率、死亡人数、死亡率、危险因素等数据。采用Joinpoint回归分析计算死亡率和DALY率的年度平均百分比变化(annual average percentage change,AAPC)以及95%置信区间(confidence interval,CI)。结果2019年我国出生窒息/创伤所致新生儿脑病死亡率为1139.527人/10万,DALY率为101275.239人年/10万,与1990年相比,均下降了76.23%。其中,男性和女性新生儿的死亡率分别为1230.738人/10万、1033.004人/10万,DALY率分别为109381.824人年/10万、91807.766人年/10万;0~6 d和7~28 d新生儿的死亡率分别为4022.626人/10万、178.166人/10万,DALY率分别为357481.444人年/10万、15844.063人年/10万。1990—2019年出生窒息/创伤所致新生儿脑病死亡率和DALY率的AAPC均为-4.88[95%CI(-5.17,-4.59)]。小于胎龄儿、早产、环境颗粒污染物和固体燃料燃烧的家庭污染是我国出生窒息/创伤所致新生儿脑病的主要危险因素。结论相较于1990年,2019年我国出生窒息/创伤所致新生儿脑病死亡率、DALY率均呈下降趋势,出生早期男性儿童的疾病负担高于女性儿童,因此应针对小于胎龄儿、早产、环境颗粒物污染、固体燃料燃烧的家庭污染等危险因素制定政策,继续重视孕期保健服务,以期进一步降低出生窒息/创伤所致新生儿脑病的疾病负担。

Objective To analyze the disease burden and its trend of neonatal encephalopathy due to birth asphyxia and trauma in China from 1990 to 2019.Methods From the Global Burden of Disease Study 2019,data about disability-adjusted life years(DALYs),DALY rates,mortality,mortality rates and risk factors for neonatal encephalopathy due to birth asphyxia and trauma in China from 1990 to 2019 were extracted.The Joinpoint regression analysis was employed to calculate the annual average percentage change(AAPC)and 95%confidence intervals(CI)of mortality rate and DALY rate.Results In 2019,the mortality rate for neonatal encephalopathy due to birth asphyxia and trauma in China was 1139.527 people per 100000,and the DALY rate was 101275.239 person years per 100000,both of which had decreased by 76.23%compared to 1990.Among which,the mortality rates for male and female neonates were 1230.738 people per 100000 and 1033.004 people per 100000,respectively,and DALY rates were 109381.824 person years per 100000 and 91807.766 person years per 100000,respectively;the mortality rates for neonates aged 0 to 6 days and 7 to 28 days were 4022.626 people per 100000 and 178.166 people per 100000,respectively,and DALY rates were 357481.444 person years per 100000 and 15844.063 person years per 100000,respectively.The AAPC for mortality rate and DALY rate from 1990 to 2019 was both-4.88[95%CI(-5.17,-4.59)].Small than gestational age,premature birth,environmental particulate pollutants,and household pollution from solid fuel combustion were the main risk factors for neonatal encephalopathy caused by birth asphyxia and trauma in China.Conclusion Compared to 1990,the mortality rate and DALY rate for neonatal encephalopathy due to birth asphyxia and trauma in China in 2019 showed a declining trend.The disease burden for male children in the early neonatal period was higher than that for female children.Policies should be formulated to address factors such as being small gestational age,preterm birth,ambient particulate matter pollution,and household pollution from the burning of solid fuels,and to continue to focus on prenatal care services,with the aim of reducing the disease burden of neonatal encephalopathy due to birth asphyxia and trauma.