International Journal of Clinical Research
International Journal of Clinical Research. 2025; 9: (11) ; 10.12208/j.ijcr.20250529 .
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1 安徽医科大学第二附属医院儿科 安徽合肥
2 安徽医科大学附属阜阳医院儿科 安徽阜阳
*通讯作者： 程雁,单位： 安徽医科大学第二附属医院儿科 安徽合肥；
背景 获取关于新生儿黄疸（Neonatal Jaundice, NNJ）负担的最新估计数据，并分析其在全球与地区层面的变化趋势，对于制定循证医学策略、预防措施以及优化卫生资源配置具有重要意义。本研究基于1990年至2021年的数据，对全球及各地区新生儿黄疸的疾病负担进行了系统分析，并对其至2029年的发展趋势进行了预测。通过对时间趋势的综合评估，本研究旨在为公共卫生政策的制定及临床实践提供科学依据。方法 本研究利用全球疾病负担（Global Burden of Disease, GBD）2021数据库的数据，分析了新生儿黄疸疾病负担的时间趋势。主要指标包括寿命损失年（Years of Life Lost, YLLs）、伤残生存年（Years Lived with Disability, YLDs）和伤残调整寿命年（Disability-Adjusted Life Years, DALYs）在1990年至2021年的变化。研究在全球及各社会人口学指数（Sociodemographic Index, SDI）地区层面进行分析，并基于GBD比较风险评估模型探讨了与NNJ相关的危险因素。采用Joinpoint回归模型识别时间变化的趋势拐点，进一步利用自回归综合滑动平均（ARIMA）模型预测至2029年的疾病负担变化。结果 NNJ在不同SDI水平地区间呈现显著差异。高SDI地区在研究期间持续保持最低的绝对值及年龄标化疾病负担，而低SDI地区则负担最高，尤其在YLDs方面。中等SDI地区表现出中间趋势，YLLs和DALYs均显著下降。总体上，全球YLLs率与DALYs率呈下降趋势，但YLDs率仍持续上升。性别差异明显，男性的DALYs和YLLs始终高于女性。NNJ相关的主要危险因素负担总体呈下降趋势，但低出生体重与早产仍是主要贡献因素。ARIMA模型预测未来八年YLLs率和DALYs率将继续下降，而YLDs率则呈持续上升趋势。结论 研究结果显示，新生儿黄疸相关的死亡负担显著下降，表明防治措施取得了重要成效；但长期伤残负担仍在上升，提示需在低资源地区加强神经发育随访及早期干预。应特别关注男性新生儿的黄疸相关健康问题。未来应强化神经发育监测、优化高危新生儿管理路径，并完善出院后随访体系，从而减少NNJ导致的长期不良结局。
Background Obtaining the latest estimates of the burden of neonatal jaundice (NNJ) and analyzing its changing trends at the global and regional levels are of great significance for formulating evidence-based medical strategies, preventive measures, and optimizing health resource allocation. This study conducted a systematic analysis of the global and regional disease burden of neonatal jaundice based on data from 1990 to 2021 and predicted its development trend until 2029. Through a comprehensive assessment of the temporal trends, this study aims to provide a scientific basis for the formulation of public health policies and clinical practice. Methods This study utilized data from the Global Burden of Disease (GBD) 2021 database to analyze the temporal trends of the disease burden of neonatal jaundice. The main indicators included Years of Life Lost (YLLs), Years Lived with Disability (YLDs), and Disability-Adjusted Life Years (DALYs) from 1990 to 2021. The analysis was conducted at the global and regional levels of the Sociodemographic Index (SDI), and the GBD comparative risk assessment model was used to explore the risk factors associated with NNJ. The Joinpoint regression model was used to identify the turning points of temporal changes, and the Autoregressive Integrated Moving Average (ARIMA) model was further utilized to predict the disease burden changes until 2029. Results There were significant differences in the burden of NNJ among regions with different SDI levels. High SDI regions maintained the lowest absolute and age-standardized disease burden throughout the study period, while low SDI regions had the highest burden, especially in YLDs. Middle SDI regions showed an intermediate trend, with significant decreases in YLLs and DALYs. Overall, the global rates of YLLs and DALYs showed a downward trend, but the rate of YLDs continued to rise. Gender differences were evident, with males consistently having higher DALYs and YLLs than females. The burden of major risk factors related to NNJ generally decreased, but low birth weight and preterm birth remained the main contributing factors. The ARIMA model predicted that the rates of YLLs and DALYs would continue to decline in the next eight years, while the rate of YLDs would continue to rise. Conclusion The study results show that the mortality burden related to neonatal jaundice has significantly decreased, indicating that prevention and treatment measures have achieved important results; however, the long-term disability burden is still on the rise, suggesting that enhanced neurodevelopmental follow-up and early intervention should be strengthened in low-resource regions. Special attention should be paid to the health problems related to jaundice in male newborns. In the future, it is necessary to strengthen neurodevelopmental monitoring, optimize the management pathways for high-risk newborns, and improve the follow-up system after discharge to reduce the long-term adverse outcomes caused by NNJ.
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