A preliminary analysis of global neonatal disorders burden attributable to PM2.5 from 1990 to 2019

Background: Prenatal fine particulate matter (PM2.5) exposure is related to various neonatal diseases (ND). However, data and studies assessing the neonatal disease burden caused by PM2.5 at the global level are limited, especially comparing countries with various socioeconomic development levels. We, therefore, assessed three-decades spatio-temporal changes in neonatal disease burden from 1990 at a national level, combined with the socio-demographic index (SDI). Methods: We extracted statistics from the Global Burden of Disease Study database for this retrospective study, and analyzed differences in the age-standardized mortality rate (ASMR) of ND and five sub-causes related to PM2.5 by gender, nationality, and SDI. To describe the trend of ASMR, the Joinpoint model was adopted to predict the annual percentage change (APC) and the average annual percentage changes (AAPCs). We executed the Gaussian process regression model to predict the relevance between SDI and ASMR. Results: The ND burden associated with PM2.5 kept rising since 1990, especially in low-middle SDI regions, South Asia, and Sub-Saharan Africa, and the sex ratio of ASMR was >1 at the global level and all five SDI regions. The leading cause of death was neonatal preterm birth. The global ASMR level of ND was 2.09 per 100,000 population in 2019 and AAPCs was 0.91 (98 % CI: 0.28, 1.55) meanwhile AAPCs decreased with rising SDI levels. The decreasing trend of ASMR in ND was detected in regions with higher SDI, such as North America, Europe, and Australasia. Conclusions: In the past three decades, the global burden of ND related to PM2.5 has ascended considerably in lower SDI regions hence PM2.5 is still considered a notable environmental hazard factor for newborn diseases.