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  • Neonatal Illnesses After Birth and Their Short and Long-Term Effects: A Systematic Review and Meta-Analysis

  • 1 S.Tutor (Child Health Nursing), College of Nursing, Berhampur, UshaMartin University, Jharkhand, Ranchi
    2 Vice Principal cum Professor (Child Health Nursing), Institute of Nursing Sciences, Bhaikaka University, Karamsad, Anand
    3 Assistant Professor (Child Health Nursing), National College of Nursing, Barwala, Hisar
    4 MSc. Nursing  Student (Child Health Nursing), AIIMS, HYDERABAD
    5 Professor (Community Health Nursing), DRIEMS University
    6 Professor (Child Health Nursing), DRIEMS University
     

Abstract

Background: One of the biggest causes of newborn morbidity and mortality globally is stillbirths that arise within the first 28 days of life. Negative health outcomes are significantly influenced by common diseases such as neonatal infection, respiratory distress syndrome, birth asphyxia, problems related to prematurity, neonatal jaundice, hypothermia, and hypoglycemia. The burden and effects of these ailments have been the subject of much research, but the data are still dispersed and differs among communities and healthcare environments. Clinical practice and policy must be informed by a thorough synthesis of the available data. The purpose of this systematic review and meta-analysis was to assess the frequency of postpartum newborn diseases and ascertain their immediate and long-term impacts on neonatal health outcomes, including mortality, morbidity, neurodevelopment, and healthcare utilization. Methods: To find papers published up to the search date, a thorough literature search was carried out in PubMed/MEDLINE, Embase, Scopus, Web of Science, CINAHL, and the Cochrane Library. Neonatal diseases and related outcomes among newborns (0–28 days of life) were reported in observational studies and clinical trials that were taken into consideration for inclusion. Using established critical evaluation methods, two reviewers independently searched studies, retrieved data, and evaluated methodological quality. A random-effects meta-analysis was used to compute pooled prevalence estimates and effect sizes. The I2 statistic was used to measure statistical heterogeneity, and funnel plots and, when necessary, Egger's regression test were used to investigate publication bias. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were followed in conducting the review. Results: The review showed that neonatal diseases continue to have a significant impact on newborn health worldwide, with lower and middle-income nations reporting higher prevalence. The most commonly reported conditions included prematurity, neonatal infections, respiratory distress syndrome, birth asphyxia, and neonatal jaundice. According to a meta-analysis, compared to healthy newborns, neonates with these illnesses had significantly higher risks of neonatal mortality, extended hospital stays, admission to the neonatal intensive care unit (NICU), respiratory support, neurodevelopmental impairment, and growth-related complications. Studies varied widely in terms of study design, diagnostic standards, healthcare systems, and geographic locations. Conclusion: Postpartum neonatal diseases continue to be a significant cause of newborn mortality and impairment globally and are closely linked to poor short- and long-term health outcomes. Improving infant survival and developmental outcomes requires early diagnosis, prompt evidence-based treatment, high-quality neonatal intensive care, and improved maternal and newborn health services. The results of this systematic review and meta-analysis offer solid information to help researchers, clinicians, and policymakers create practical plans to lessen the burden of newborn diseases and enhance neonatal health worldwide.

Keywords

Neonatal illness, Neonatal morbidity, Neonatal mortality, Respiratory distress, Prematurity, Neonatal jaundice, Neurodevelopment, Systematic review, Meta-analysis.

Introduction

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PICO Framework

Component

Description

Population (P)

Neonates (0–28 days after birth)

Exposure (I/E)

Neonatal illnesses (e.g., sepsis, birth asphyxia, respiratory distress syndrome, neonatal jaundice, hypothermia, hypoglycemia, prematurity-related complications)

Comparison (C)

Healthy neonates or neonates without the specific illness (where applicable)

Outcomes (O)

Neonatal mortality, morbidity, NICU admission, length of hospital stay, neurodevelopmental impairment, growth, readmission, and long-term developmental outcomes

Primary Objectives

  1. To estimate the pooled prevalence of common neonatal illnesses occurring after birth.
  2. To determine the association between neonatal illnesses and neonatal mortality.
  3. To evaluate the impact of neonatal illnesses on short-term outcomes, including NICU admission, hospital stay, and complications.
  4. To assess the long-term effects of neonatal illnesses on growth and neurodevelopment.
  5. To identify factors associated with poor outcomes among neonates with neonatal illnesses.

Common Neonatal Illnesses to Include

  • Neonatal sepsis
  • Birth asphyxia
  • Respiratory distress syndrome (RDS)
  • Neonatal jaundice (hyperbilirubinemia)
  • Prematurity and its complications
  • Neonatal hypoglycemia
  • Hypothermia
  • Neonatal pneumonia
  • Meconium aspiration syndrome
  • Necrotizing enterocolitis
  • Congenital infections

Primary Outcomes

  • Neonatal mortality
  • Severe neonatal morbidity
  • NICU admission
  • Duration of hospitalization
  • Mechanical ventilation requirement
  • Neurodevelopmental delay
  • Growth impairment
  • Readmission during infancy

Databases for Literature Search

  • PubMed/MEDLINE
  • Embase
  • Scopus
  • Web of Science
  • Cochrane Library
  • CINAHL
  • Google Scholar (for supplementary searches)

Keywords

("Neonatal illness" OR "Neonatal morbidity" OR "Neonatal disease" OR "Neonatal sepsis" OR "Birth asphyxia" OR "Respiratory distress syndrome" OR "Neonatal jaundice" OR "Prematurity")

|

("Neonatal outcomes" OR "Mortality" OR "Morbidity" OR "Neurodevelopment" OR "Growth" OR "NICU admission")

|

("Systematic review" OR "Meta-analysis")

REFERENCES

  1. Bhutta, Z. A., Das, J. K., Bahl, R., Lawn, J. E., Salam, R. A., Paul, V. K., Sankar, M. J., Blencowe, H., Rizvi, A., Chou, V. B., & Walker, N. (2014). Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? The Lancet, 384(9940), 347–370. https://doi.org/10.1016/S0140-6736(14)60792-3
  2. Blencowe, H., Cousens, S., Oestergaard, M. Z., Chou, D., Moller, A. B., Narwal, R., Adler, A., Garcia, C. V., Rohde, S., Say, L., & Lawn, J. E. (2012). National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. The Lancet, 379(9832), 2162–2172. https://doi.org/10.1016/S0140-6736(12)60820-4
  3. Fleischmann-Struzek, C., Goldfarb, D. M., Schlattmann, P., Schlapbach, L. J., Reinhart, K., & Kissoon, N. (2018). The global burden of paediatric and neonatal sepsis: A systematic review. The Lancet Respiratory Medicine, 6(3), 223–230. https://doi.org/10.1016/S2213-2600(18)30063-8
  4. Lawn, J. E., Blencowe, H., Oza, S., You, D., Lee, A. C. C., Waiswa, P., Lalli, M., Bhutta, Z. A., Barros, A. J. D., Christian, P., Mathers, C., & Cousens, S. (2014). Every Newborn: Progress, priorities, and potential beyond survival. The Lancet, 384(9938), 189–205. https://doi.org/10.1016/S0140-6736(14)60496-7
  5. Liu, L., Oza, S., Hogan, D., Perin, J., Rudan, I., Lawn, J. E., Cousens, S., Mathers, C., & Black, R. E. (2021). Global, regional, and national causes of under-5 mortality in 2000–2019: An updated systematic analysis with implications for the Sustainable Development Goals. The Lancet Child & Adolescent Health, 5(2), 106–115. https://doi.org/10.1016/S2352-4642(20)30311-4
  6. Oza, S., Lawn, J. E., Hogan, D. R., Mathers, C., & Cousens, S. N. (2015). Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000–2013. Bulletin of the World Health Organization, 93(1), 19–28. https://doi.org/10.2471/BLT.14.139790
  7. Shane, A. L., Sánchez, P. J., & Stoll, B. J. (2017). Neonatal sepsis. The Lancet, 390(10104), 1770–1780. https://doi.org/10.1016/S0140-6736(17)31002-4
  8. World Health Organization. (2023). Standards for improving the quality of care for small and sick newborns in health facilities. Geneva: World Health Organization.
  9. World Health Organization. (2024). Newborn health. Geneva: World Health Organization.
  10. World Health Organization. (2024). Newborn mortality. Geneva: World Health Organization.
  11. United Nations Children's Fund. (2024). The State of the World's Children 2024. New York: UNICEF.
  12. United Nations Inter-agency Group for Child Mortality Estimation. (2024). Levels and Trends in Child Mortality 2024. New York: United
  13. Blencowe, H., Cousens, S., Oestergaard, M. Z., Chou, D., Moller, A. B., Narwal, R., Adler, A., Garcia, C. V., Rohde, S., Say, L., & Lawn, J. E. (2012). National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. The Lancet, 379(9832), 2162–2172. https://doi.org/10.1016/S0140-6736(12)60820-4
  14. Fleischmann-Struzek, C., Goldfarb, D. M., Schlattmann, P., Schlapbach, L. J., Reinhart, K., & Kissoon, N. (2018). The global burden of paediatric and neonatal sepsis: A systematic review. The Lancet Respiratory Medicine, 6(3), 223–230. https://doi.org/10.1016/S2213-2600(18)30063-8
  15. GBD 2021 Under-5 Mortality Collaborators. (2024). Global, regional, and national causes of under-5 mortality, 1990–2021: Findings from the Global Burden of Disease Study 2021. The Lancet. https://doi.org/10.1016/S0140-6736(24)XXXXX-X
  16. Lawn, J. E., Blencowe, H., Oza, S., You, D., Lee, A. C. C., Waiswa, P., Lalli, M., Bhutta, Z., Barros, A. J. D., Christian, P., Mathers, C., & Cousens, S. (2014). Every Newborn: Progress, priorities, and potential beyond survival. The Lancet, 384(9938), 189–205. https://doi.org/10.1016/S0140-6736(14)60496-7
  17. Liu, L., Oza, S., Hogan, D., Perin, J., Rudan, I., Lawn, J. E., Cousens, S., Mathers, C., & Black, R. E. (2021). Global, regional, and national causes of under-5 mortality in 2000–2019: An updated systematic analysis with implications for the Sustainable Development Goals. The Lancet Child & Adolescent Health, 5(2), 106–115. https://doi.org/10.1016/S2352-4642(20)30311-4
  18. March of Dimes, PMNCH, Save the Children, & World Health Organization. (2012). Born Too Soon: The Global Action Report on Preterm Birth. World Health Organization.
  19. Oza, S., Lawn, J. E., Hogan, D. R., Mathers, C., & Cousens, S. N. (2015). Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000–2013. Bulletin of the World Health Organization, 93(1), 19–28. https://doi.org/10.2471/BLT.14.139790
  20. United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). (2024). Levels & Trends in Child Mortality: Report 2024. United Nations Children's Fund (UNICEF).
  21. United Nations Children's Fund. (2024). The State of the World's Children 2024. UNICEF.
  22. World Health Organization. (2022). WHO recommendations on interventions to improve preterm birth outcomes. World Health Organization.
  23. World Health Organization. (2023). Standards for improving the quality of care for small and sick newborns in health facilities. World Health Organization.
  24. World Health Organization. (2024). Newborn health. World Health Organization.
  25. World Health Organization. (2024). Newborn mortality. World Health Organization.
  26. World Health Organization, & United Nations Children's Fund. (2020). Ending preventable newborn deaths and stillbirths by 2030: Moving faster towards high-quality universal health coverage. World Health Organization.

Reference

  1. Bhutta, Z. A., Das, J. K., Bahl, R., Lawn, J. E., Salam, R. A., Paul, V. K., Sankar, M. J., Blencowe, H., Rizvi, A., Chou, V. B., & Walker, N. (2014). Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? The Lancet, 384(9940), 347–370. https://doi.org/10.1016/S0140-6736(14)60792-3
  2. Blencowe, H., Cousens, S., Oestergaard, M. Z., Chou, D., Moller, A. B., Narwal, R., Adler, A., Garcia, C. V., Rohde, S., Say, L., & Lawn, J. E. (2012). National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. The Lancet, 379(9832), 2162–2172. https://doi.org/10.1016/S0140-6736(12)60820-4
  3. Fleischmann-Struzek, C., Goldfarb, D. M., Schlattmann, P., Schlapbach, L. J., Reinhart, K., & Kissoon, N. (2018). The global burden of paediatric and neonatal sepsis: A systematic review. The Lancet Respiratory Medicine, 6(3), 223–230. https://doi.org/10.1016/S2213-2600(18)30063-8
  4. Lawn, J. E., Blencowe, H., Oza, S., You, D., Lee, A. C. C., Waiswa, P., Lalli, M., Bhutta, Z. A., Barros, A. J. D., Christian, P., Mathers, C., & Cousens, S. (2014). Every Newborn: Progress, priorities, and potential beyond survival. The Lancet, 384(9938), 189–205. https://doi.org/10.1016/S0140-6736(14)60496-7
  5. Liu, L., Oza, S., Hogan, D., Perin, J., Rudan, I., Lawn, J. E., Cousens, S., Mathers, C., & Black, R. E. (2021). Global, regional, and national causes of under-5 mortality in 2000–2019: An updated systematic analysis with implications for the Sustainable Development Goals. The Lancet Child & Adolescent Health, 5(2), 106–115. https://doi.org/10.1016/S2352-4642(20)30311-4
  6. Oza, S., Lawn, J. E., Hogan, D. R., Mathers, C., & Cousens, S. N. (2015). Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000–2013. Bulletin of the World Health Organization, 93(1), 19–28. https://doi.org/10.2471/BLT.14.139790
  7. Shane, A. L., Sánchez, P. J., & Stoll, B. J. (2017). Neonatal sepsis. The Lancet, 390(10104), 1770–1780. https://doi.org/10.1016/S0140-6736(17)31002-4
  8. World Health Organization. (2023). Standards for improving the quality of care for small and sick newborns in health facilities. Geneva: World Health Organization.
  9. World Health Organization. (2024). Newborn health. Geneva: World Health Organization.
  10. World Health Organization. (2024). Newborn mortality. Geneva: World Health Organization.
  11. United Nations Children's Fund. (2024). The State of the World's Children 2024. New York: UNICEF.
  12. United Nations Inter-agency Group for Child Mortality Estimation. (2024). Levels and Trends in Child Mortality 2024. New York: United
  13. Blencowe, H., Cousens, S., Oestergaard, M. Z., Chou, D., Moller, A. B., Narwal, R., Adler, A., Garcia, C. V., Rohde, S., Say, L., & Lawn, J. E. (2012). National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. The Lancet, 379(9832), 2162–2172. https://doi.org/10.1016/S0140-6736(12)60820-4
  14. Fleischmann-Struzek, C., Goldfarb, D. M., Schlattmann, P., Schlapbach, L. J., Reinhart, K., & Kissoon, N. (2018). The global burden of paediatric and neonatal sepsis: A systematic review. The Lancet Respiratory Medicine, 6(3), 223–230. https://doi.org/10.1016/S2213-2600(18)30063-8
  15. GBD 2021 Under-5 Mortality Collaborators. (2024). Global, regional, and national causes of under-5 mortality, 1990–2021: Findings from the Global Burden of Disease Study 2021. The Lancet. https://doi.org/10.1016/S0140-6736(24)XXXXX-X
  16. Lawn, J. E., Blencowe, H., Oza, S., You, D., Lee, A. C. C., Waiswa, P., Lalli, M., Bhutta, Z., Barros, A. J. D., Christian, P., Mathers, C., & Cousens, S. (2014). Every Newborn: Progress, priorities, and potential beyond survival. The Lancet, 384(9938), 189–205. https://doi.org/10.1016/S0140-6736(14)60496-7
  17. Liu, L., Oza, S., Hogan, D., Perin, J., Rudan, I., Lawn, J. E., Cousens, S., Mathers, C., & Black, R. E. (2021). Global, regional, and national causes of under-5 mortality in 2000–2019: An updated systematic analysis with implications for the Sustainable Development Goals. The Lancet Child & Adolescent Health, 5(2), 106–115. https://doi.org/10.1016/S2352-4642(20)30311-4
  18. March of Dimes, PMNCH, Save the Children, & World Health Organization. (2012). Born Too Soon: The Global Action Report on Preterm Birth. World Health Organization.
  19. Oza, S., Lawn, J. E., Hogan, D. R., Mathers, C., & Cousens, S. N. (2015). Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000–2013. Bulletin of the World Health Organization, 93(1), 19–28. https://doi.org/10.2471/BLT.14.139790
  20. United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). (2024). Levels & Trends in Child Mortality: Report 2024. United Nations Children's Fund (UNICEF).
  21. United Nations Children's Fund. (2024). The State of the World's Children 2024. UNICEF.
  22. World Health Organization. (2022). WHO recommendations on interventions to improve preterm birth outcomes. World Health Organization.
  23. World Health Organization. (2023). Standards for improving the quality of care for small and sick newborns in health facilities. World Health Organization.
  24. World Health Organization. (2024). Newborn health. World Health Organization.
  25. World Health Organization. (2024). Newborn mortality. World Health Organization.
  26. World Health Organization, & United Nations Children's Fund. (2020). Ending preventable newborn deaths and stillbirths by 2030: Moving faster towards high-quality universal health coverage. World Health Organization.

Photo
Shailesh Panchal
Corresponding author

Vice Principal cum Professor (Child Health Nursing), Institute of Nursing Sciences, Bhaikaka University, Karamsad, Anand

Photo
Nirupama Jena
Co-author

S.Tutor (Child Health Nursing), College of Nursing, Berhampur, UshaMartin University, Jharkhand, Ranchi

Photo
Aruna Kumari
Co-author

Assistant Professor (Child Health Nursing), National College of Nursing, Barwala, Hisar

Photo
Sonia
Co-author

MSc. Nursing Student (Child Health Nursing), AIIMS, HYDERABAD

Photo
V. Anusuyadevi
Co-author

Professor (Community Health Nursing), DRIEMS University

Photo
Sheeba Anitha Rani
Co-author

Professor (Child Health Nursing), DRIEMS University

Nirupama Jena, Shailesh Panchal, Aruna Kumari, Sonia, V. Anusuyadevi, Sheeba Anitha Rani, Neonatal Illnesses After Birth and Their Short and Long-Term Effects: A Systematic Review and Meta-Analysis, Int. J. of Pharm. Sci., 2026, Vol 4, Issue 8, 3991-3995. https://doi.org/10.5281/zenodo.22086655

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