Global, regional, and national burden of ambient and household PM2.5-related neonatal disorders, 1990-2019

Previous studies have shown a relationship between fine particulate matter (PM2.5) exposure and an increased risk of neonatal disorders. Considering the huge burden of neonatal disorders, we assessed spatiotemporal trends of neonatal disorders burden caused by ambient and household PM2.5 at the global, regional, and national levels from 1990 to 2019. The number, rate, and population attributable fraction (PAF) of ambient and household PM2.5-related neonatal disorders disability-adjusted life years (DALYs) in 204 countries and territories from 1990 to 2019 were obtained from the Global Burden of Disease Study 2019 to measure the related neonatal disorders burden by age, sex, subtype, and region. Estimated annual percentage change (EAPC) was estimated to quantify temporal trends. In 2019, approximately a fifth of the global neonatal disorders burden was attributable to PM2.5 exposure, with 7.54% for ambient PM2.5 and 13.23% for household PM2.5. Although the global neonatal dis-orders burden attributable to household PM2.5 has decreased substantially in the past 30 years, that attributable to ambient PM2.5 has increased, especially in lower sociodemographic index (SDI) regions. The highest rate and PAF of ambient PM2.5-related neonatal disorders DALYs in 2019 were in South Asia and East Asia, respectively, and the fastest increases were in Eastern Sub-Saharan Africa (for rate: EAPC symbolscript 2.55, 95% CI: 2.37-2.73) and South Asia (for PAF: EAPC symbolscript 3.88, 95% CI: 3.68-4.08). In addition, we found an inverted V-shaped between rates and PAFs of ambient PM2.5-related neonatal disorders DALYs in 2019, as well as corresponding EAPCs, and SDI, while rates and PAFs of household PM2.5-related neonatal disorders DALYs in 2019 were highly negatively correlated with SDI. In the past three decades, the global ambient PM2.5-related neonatal disorders burden largely increased, especially in lower SDI regions. Comparatively, the household PM2.5-related neonatal disorders burden decreased but still accounted for about two-thirds of the PM2.5-related neonatal disease burden.