Objective To analyze the long-term trend in the disease burden of congenital birth defects(CBDs)among neonates in China from 1990 to 2021,compare the trend with global patterns,and identify key subtypes along with their association with socioeconomic status to provide evidence for public health interventions.Methods Utilizing data from the Global Burden of Disease Study 2021(GBD 2021),we extracted indicators including disability-adjusted life years(DALYs),mortality,and prevalence for the neonatal period(＜28 days)in China,encompassing ten major CBD subtypes.Joinpoint regression analysis was employed to calculate annual percent changes and estimate annual percent changes(EAPC),with comparisons of subtype composition between 1990 and 2021.Nonlinear regression was used to assess the relationship between DALYs rates and the Socio-demographic Index(SDI).Results From 1990 to 2021,DALYs rates for neonatal CBDs declined significantly both globally and in China,with China's EAPC at-4.67％[95％CI:(—5.06,—4.28)],substantially exceeding the global average of-1.70％[95％CI:(—1.75,—1.64)].Congenital heart anomalies remained the primary burden,while neural tube defects and orofacial clefts in China showed notable reductions(EAPCs of-7.25％and-11.22％,respectively).However,DALYs rates for congenital musculoskeletal and limb anomalies exceeded global expected levels.A resurgence in the prevalence was observed post-2015,with higher burdens in males.DALYs rates exhibited a negative correlation with SDI.Conclusion China has achieved significant reductions in the neonatal CBDs burden,surpassing global trends;yet challenges persist in managing congenital heart anomalies and musculoskeletal defects.Future efforts should focus on enhancing early screening,surgical interventions,and regional equity to align with global health objectives.

Objective To analyze the long-term trend in the disease burden of congenital birth defects(CBDs)among neonates in China from 1990 to 2021,compare the trend with global patterns,and identify key subtypes along with their association with socioeconomic status to provide evidence for public health interventions.Methods Utilizing data from the Global Burden of Disease Study 2021(GBD 2021),we extracted indicators including disability-adjusted life years(DALYs),mortality,and prevalence for the neonatal period(＜28 days)in China,encompassing ten major CBD subtypes.Joinpoint regression analysis was employed to calculate annual percent changes and estimate annual percent changes(EAPC),with comparisons of subtype composition between 1990 and 2021.Nonlinear regression was used to assess the relationship between DALYs rates and the Socio-demographic Index(SDI).Results From 1990 to 2021,DALYs rates for neonatal CBDs declined significantly both globally and in China,with China's EAPC at-4.67％[95％CI:(—5.06,—4.28)],substantially exceeding the global average of-1.70％[95％CI:(—1.75,—1.64)].Congenital heart anomalies remained the primary burden,while neural tube defects and orofacial clefts in China showed notable reductions(EAPCs of-7.25％and-11.22％,respectively).However,DALYs rates for congenital musculoskeletal and limb anomalies exceeded global expected levels.A resurgence in the prevalence was observed post-2015,with higher burdens in males.DALYs rates exhibited a negative correlation with SDI.Conclusion China has achieved significant reductions in the neonatal CBDs burden,surpassing global trends;yet challenges persist in managing congenital heart anomalies and musculoskeletal defects.Future efforts should focus on enhancing early screening,surgical interventions,and regional equity to align with global health objectives.