Global Neonatal Sepsis Trends
NEONATAL sepsis rates fell globally from 1990 to 2021, yet detection rose and poverty shaped where deaths clustered across regions.
Neonatal sepsis (NS) remains a major global health challenge, with reported mortality ranging from 11% to 19% in affected newborns. In a pan-database analysis spanning 18 international datasets across 201 countries from 1990–2021, investigators mapped how NS burden has shifted over time, where disparities persist, and which factors most strongly track incidence and mortality.
Across the study period, NS prevalence increased year on year, which the authors attribute to improved detection. However, age-standardized rates showed consistent declines, suggesting that when population structure is accounted for, NS burden is trending downward overall.
Neonatal Sepsis Determinants Differ for Incidence and Mortality
The analysis highlighted distinct correlates for NS incidence versus death. For incidence, the authors identified novel associations including European ancestry as the strongest correlate, alongside systolic and diastolic blood pressure metrics, and an inverse association with the Human Development Index (HDI). Using risk parsimonious modeling with confounder adjustment, the team developed a streamlined predictive model combining diastolic blood pressure, Global Hunger Index, and European ancestry. This model demonstrated cross-regional predictive capability (r=0.727), indicating it performed consistently across different world regions in this dataset.
For mortality, the pattern shifted decisively toward socioeconomic drivers. Mortality showed positive associations with Global Hunger Index and food insecurity, and inverse associations with Inequality Adjusted HDI. In other words, markers of structural disadvantage aligned more closely with where newborn deaths from neonatal sepsis concentrate than clinical or biometric correlates alone.
Clinical Takeaway for U.S. Practice
While this analysis is global, it underscores a clinically familiar message: neonatal sepsis outcomes are shaped by both medical and social conditions. The authors argue that reducing NS burden requires a dual approach, improving medical care while also addressing fundamental socioeconomic disparities, particularly in resource-limited settings.
Reference: Chang ZL et al. Global trends, regional disparities and key determinants of neonatal sepsis: A pan-database analysis from 1990 to 2021. Computers in Biology and Medicine. 2026; doi:10.1016/j.compbiomed.2026.111537.
