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Temporal trends and patterns in neonatal sepsis mortality across 194 countries, 2000–2021, with projections up to 2050

Journal of Perinatology (2026) Cite this article

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Abstract

Objective

Neonatal sepsis remains a leading cause of neonatal mortality, yet comprehensive evaluations of its current and future burden are limited. This study assessed global, regional, and national trends and projected mortality through 2050.

Study design

Data from the UN child mortality database (2000–2021) across 194 countries were analyzed. Neonatal sepsis was defined using ICD-10 codes P35–P39, excluding P37.3–P37.4. Trends were assessed using annual percentage change, and mortality was projected under three scenarios: continuation of current trends, convergence to high-income country trends, and attainment of the greatest observed national reduction.

Results

In 2021, the global neonatal sepsis mortality rate was 129.34 per 100,000 live births, a 41.6% reduction since 2000. West and Central Africa had the highest mortality and slowest decline. By 2050, mortality is projected to decline to 61.49 per 100,000.

Conclusions

Despite progress, substantial regional disparities persist, highlighting the need for targeted interventions in high-burden regions.

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Fig. 1: Global distribution of neonatal sepsis mortality rates in 2000 and 2021.
The alternative text for this image may have been generated using AI.
Fig. 2: Temporal trends and projected scenarios of neonatal sepsis mortality rates across UNICEF regions.
The alternative text for this image may have been generated using AI.

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Data availability

To download the data used in these analyses, please visit the UN IGME https://childmortality.org/causes-of-death/data.

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Funding

This research was supported by the Ministry of Science and ICT (RS-2024-00509257, RS-2026-25495984, and IITP-2026-RS-2024-00438239) and the Ministry of Health & Welfare (RS-2025-02220492), Republic of Korea. The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Author information

Author notes

  1. These authors contributed equally: Soeun Kim, Kyeongmin Lee, Tae Hyeon Kim.

Authors and Affiliations

  1. Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea

    Soeun Kim, Kyeongmin Lee, Tae Hyeon Kim, Jaehyeong Cho, Jiyeon Oh, Sooji Lee, Seohyun Hong, Dongjin Yeo, Yerin Hwang, Selin Woo & Dong Keon Yon

  2. Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea

    Soeun Kim, Kyeongmin Lee, Tae Hyeon Kim & Dong Keon Yon

  3. Department of Regulatory Science, Kyung Hee University, Seoul, South Korea

    Kyeongmin Lee & Dong Keon Yon

  4. Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea

    Jiyeon Oh, Sooji Lee, Seohyun Hong, Dongjin Yeo, Yerin Hwang, Selin Woo & Dong Keon Yon

  5. Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK

    Lee Smith

  6. Department of Public Health, Biruni University, Faculty of Medicine, Istanbul, Turkey

    Lee Smith

  7. Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    André Hajek

  8. Division of Nephrology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea

    Hyeon Seok Hwang

  9. Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea

    Dong Keon Yon

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  1. Soeun Kim
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Contributions

DKY had full access to all data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. All authors have approved the final version of the manuscript before submission. Study concept and design: SK, KL, THK and DKY; acquisition, analysis, or interpretation of data: SK, KL, THK and DKY; Drafting of the manuscript: SK, KL, THK and DKY; critical revision of the manuscript for important intellectual content: all authors; statistical analysis: SK, KL, THK and DKY; study supervision: DKY; DKY supervised the study and is the guarantor of this study. SK, KL, and THK contributed equally to this study. The corresponding author attests that all listed authors satisfy the authorship criteria and that no others meeting the criteria have been omitted.

Corresponding author

Correspondence to Dong Keon Yon.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study used publicly available, de-identified, and aggregated data obtained from the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) database (childmortality.org). All methods were performed in accordance with relevant guidelines and regulations. As this study used anonymized, publicly available secondary data and did not involve individual-level data or direct participation of humans or animals, ethical approval and informed consent to participate were not required. Consent for publication of identifiable images was not applicable.

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Kim, S., Lee, K., Kim, T.H. et al. Temporal trends and patterns in neonatal sepsis mortality across 194 countries, 2000–2021, with projections up to 2050. J Perinatol (2026). https://doi.org/10.1038/s41372-026-02719-5

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