Newborn deaths from birth injuries and prematurity are falling—but Africa’s slowdown threatens global 2040 targets

Zhejiang University

Facebook

XLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Global distribution of the under-five mortality rates (U5MR) due to birth asphyxia/trauma and prematurity, in 2000 and 2021. a Birth asphyxia/trauma-2000; b Birth asphyxia/trauma-2010; c Prematurity-2000; d Prematurity-2010.

view more 

Credit: World Journal of Pediatrics

A global analysis spanning 194 countries reveals a mixed picture for newborn survival: deaths caused by birth asphyxia, trauma, and prematurity have declined markedly since 2000, yet progress is slowing in many low- and middle-income countries, particularly across sub-Saharan Africa. Researchers warn that without accelerated intervention, some of the world's most vulnerable regions will remain far from achieving international child survival targets by 2040.More than 2.4 million newborns died in 2019, and intrapartum complications together with preterm birth remain the leading killers. The Sustainable Development Goal 3.2 aims to reduce neonatal mortality to less than 12 per 1000 live births by 2030, but recent assessments indicate that 64 countries are off track. Low- and middle-income countries have seen a worrying deceleration in neonatal mortality decline, partly because high-cost neonatal resuscitation programs and intensive care models are difficult to implement in resource-limited settings. Based on these challenges, there is an urgent need to understand country-specific trends and to project future scenarios that can inform targeted policy.

A team led by researchers at Kyung Hee University College of Medicine, Seoul, South Korea, published (DOI: 10.1007/s12519-026-01045-2) the findings on May 28, 2026, in World Journal of Pediatrics. Using the cause-of-death data from United Nations Inter-Agency Group for Child Mortality Estimation , they analyzed neonatal and under-5 mortality from birth asphyxia or trauma and prematurity across 194 countries between 2000 and 2021, then projected outcomes to 2040 under three different scenarios.

Globally, neonatal mortality from birth asphyxia/trauma fell from 7.52 to 4.18 during 2000–2021, while prematurity-related neonatal deaths dropped from 10.63 to 6.49. Yet the reduction slowed between 2010 and 2021 compared with the previous decade. The disparity between regions remains striking. In 2021, newborns in West and Central Africa were nearly 30 times more likely to die from birth asphyxia or trauma than those in North America. Eastern and Southern Africa and West and Central Africa also showed the smallest percentage declines since 2000. In contrast, East Asia and Pacific and Eastern Europe and Central Asia achieved the largest reductions. South Asia, which had the highest rates in 2000, made substantial progress. The study further found that countries with lower scores on the Human Development Index, Universal Health Coverage service coverage index, and Healthcare Access and Quality index experienced slower mortality declines. Interestingly, the greatest improvements occurred not in the wealthiest nations but in those at intermediate-to-upper levels of socioeconomic development, suggesting that targeted investments can yield rapid gains. Under a "regional best-performer" scenario, global neonatal mortality from these causes could fall below 1 by 2040, a dramatic improvement from current trends.

"World has made real progress, but the slowdown in Africa is a wake-up call," the authors said. "If West and Central Africa had the same rate of decline as the best-performing country, neonatal deaths from birth asphyxia could drop to near zero by 2040. But under current trends, they will remain devastatingly high. This gap between where we are and where we could be is massive. We don't need futuristic technology, instead, we need scale up low-cost, proven tools like the Helping Babies Breathe program and make sure midwives are trained and supported. Our projections show the accelerated progress is absolutely achievable."

The study provides one of the most comprehensive assessments to date of global trends in mortality related to birth asphyxia, trauma, and prematurity, offering policymakers a roadmap for prioritizing investments in newborn health.. The authors stress that scaling up midwife-delivered interventions could prevent up to 64% of neonatal deaths, even without expensive equipment. For low-resource settings, programs such as Helping Babies Breathe and continuous positive airway pressure for preterm respiratory distress are effective but require reliable training, equipment, and referral systems. Countries with the highest mortality need to shift delivery care from homes to facilities that have skilled staff, emergency obstetric services, and neonatal resuscitation. Strengthening health systems, ensuring 24/7 availability of skilled birth attendants, and empowering midwives are the most cost-effective strategies to close the equity gap by 2040.

###

References

DOI

10.1007/s12519-026-01045-2

Original Source URL

https://doi.org/10.1007/s12519-026-01045-2

Funding information

This work was supported by a grant from Kyung Hee University in 2025 (KHU-20251285).

About World Journal of Pediatrics

World Journal of Pediatrics is a monthly, peer-reviewed academic journal that publishes original research articles, reviews, and special reports covering all aspects of pediatrics. It welcomes contributions from pediatricians and researchers worldwide, focusing on the latest developments in pediatric clinical practice, pediatric surgery, preventive child healthcare, pharmacology, stomatology, and biomedicine, as well as basic and experimental sciences. The journal provides an international platform for academic exchange and dissemination of medical research findings. All submissions undergo rigorous peer review by at least two experts. Committed to efficient manuscript processing, the journal aims to deliver final decisions within two months, with outstanding papers or special reports potentially accepted within one month for priority publication.

---

Journal

World Journal of Pediatrics

DOI

10.1007/s12519-026-01045-2 

Subject of Research

Not applicable

Article Title

Global and temporal trends in neonatal and under-five mortality due to birth asphyxia/trauma and prematurity (2000–2021) with projections up to 2040

 

Not everyone has equal access to pain rehabilitation

University of Gothenburg

Facebook

XLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Helene Svensdotter, Sahlgrenska Academy at the University of Gothenburg.

view more 

Credit: Photo: University of Gothenburg

 

Patients with chronic pain do not have access to specialized rehabilitation on equal terms. Education, age, sex, and region of birth appear to play a role, particularly in combination, according to a Sweden-based study from the University of Gothenburg. 

Chronic pain can affect work, everyday life, and quality of life. The study is based on 39,346 patients who were referred to specialized pain care in Sweden between 2009 and 2016. Nearly half of these patients (49.8 percent) were assessed as able to participate in a rehabilitation program. The study identifies several factors that appear to influence which patients gain access to specialized pain rehabilitation.

Among women, 52.1 percent were assessed as able to participate in specialized pain rehabilitation, compared with 44.1 percent of men. Among patients born in the Nordic countries, the proportion was 51.2 percent, compared with 44.7 percent among patients born outside the Nordic countries. Education also appeared to matter: 40.2 percent of patients with only compulsory education were assessed as able to participate, compared with 54.9 percent of patients with a university education. 

Age also played a role. Middle-aged patients were more often assessed as able to participate than both younger and older patients. The fact that the youngest patients participated less often than middle-aged patients was unexpected, since early interventions can be important both for individuals and for society. 

The study is part of Helene Svensdotter’s doctoral education. She is a physiotherapist at Regionhälsan and a doctoral student at the Sahlgrenska Academy, University of Gothenburg. 

“We see that the differences are not only linked to individual factors. It is the combination of factors such as educational level, age, sex, and region of birth that appears to influence the likelihood of gaining access to rehabilitation. This makes the findings important to consider when healthcare services review both assessment procedures and the types of interventions available to different patient groups.” 

When the researchers analyzed several factors simultaneously, the differences became more pronounced. The lowest likelihood of being offered pain rehabilitation was found among patients with a combination of primary school education and being born outside the Nordic countries, with similar patterns observed among women and men regardless of age. The highest likelihood was found among middle-aged women with a university education, regardless of whether they were born within or outside the Nordic region. 
The researchers point to several possible explanations for these differences, including language-related factors, life circumstances, the ability to participate in an extensive rehabilitation program, healthcare professionals’ assessments of patients’ conditions and circumstances, and perceptions of who is considered suitable for rehabilitation. 
The findings can be used to further develop how patients are assessed before specialized pain rehabilitation and how different types of support can be adapted. The aim is for more patients with chronic pain to receive the right intervention, regardless of their background.

---

Journal

Scandinavian Journal of Pain

DOI

10.1515/sjpain-2026-0004 

Method of Research

Observational study

Subject of Research

People

Article Title

Equal access to pain rehabilitation in Swedish tertiary care. Are sociodemographic factors associated with selection to rehabilitation?

 

86% of Brazilian children with disabling musculoskeletal pain recover, study finds

The study is the first to indicate the prognosis of the condition and identify possible factors related to recovery and recurrence.

Fundação de Amparo à Pesquisa do Estado de São Paulo

Facebook

WeChatBlueskyMessageWhatsAppEmail

Three out of every ten Brazilian children and adolescents complain of musculoskeletal pain (affecting bones, ligaments, and muscles). This common problem impacts the lives of this population and should not be underestimated. The condition, known as disabling musculoskeletal pain, causes children and adolescents to miss school and give up routine and leisure activities, despite having no connection to trauma, repetitive strain, or any other specific cause.

A study published in March in the Journal of Orthopaedic & Sports Physical Therapy involving 694 children and adolescents showed that 86% of those with disabling musculoskeletal pain recover over 18 months. However, about 32% of those who improve experience disabling pain again at some point, indicating that this is a recurrent condition requiring ongoing attention.

“It’s a type of pain that’s still greatly underestimated and understudied, despite being common. As a result, children and adolescents often receive inadequate treatment or their complaints are dismissed by their families or the healthcare system. It isn’t something you can simply wait to go away. In our study, we showed that although the pain usually disappears as suddenly as it appeared, it can persist in 14% of cases,” says Tiê Parma Yamato, an associate researcher at the Universidade Cidade de São Paulo (UNICID) in Brazil and the University of Sydney in Australia. Yamato coordinated the research.

The researchers also identified factors such as quality of life and age as important predictors of recovery. “Younger children with a better quality of life have a higher chance of spontaneous improvement. As they enter adolescence, the statistical chances of improvement decrease, which reinforces the urgency of early intervention,” she says. 

A problem for the future

Yamato explains that recurrent or disabling pain during childhood and adolescence is a known risk factor for developing chronic conditions in adulthood. “Understanding the course of that pain in childhood allows us to identify those who need early attention to potentially prevent persistent health problems in adulthood,” she states.  

She points out that chronic pain, such as lower back pain, is one of the major health issues worldwide and generates enormous financial costs for public health systems. “Addressing the root of the problem may be a way to reduce that economic and social impact in the future,” she says.

The study, supported by FAPESP, is the first to examine the prognosis of musculoskeletal pain in children and adolescents. It aims to identify potential factors related to recovery and possible recurrence episodes and to provide the first data on this condition from low- and middle-income countries. 

To this end, the researchers recruited 28 public and private schools in the Brazilian states of Ceará (Fortaleza) and São Paulo (Itu, Salto, São Sebastião, and São Paulo) and 12,036 children and adolescents. Of these, 2,688 participants, with an average age of 12, agreed to take part in the study (read more at agencia.fapesp.br/51591). 

Participants answered a questionnaire about pain capable of impacting their daily lives. Of those, 694 were monitored for 18 months. 

The back was the most frequently cited part of the body, mentioned by 51.3% of respondents, followed by the legs (42.5%) and the neck (20.5%). “But it can occur in any joint, bone, or muscle,” says Yamato. 

An underestimated condition

The researcher explains that musculoskeletal pain in children and adolescents is poorly studied and often misunderstood. As a result, it is frequently associated with a myth that has never been proven. “Often, that pain is understood and referred to as ‘growing pains.’ The problem is that currently, growing pains are more a matter of common sense than a proven diagnosis. There’s no scientific evidence that the growth process or common growth spurts in childhood and adolescence cause pain,” the researcher states.

“Perhaps because this type of pain lacks a specific cause, different conditions end up being classified as growing pains. The problem with this interpretation is that it often leads to the idea that you just need to wait for the child to grow out of it. However, scientific literature has shown various consequences of not approaching this condition with due caution,” she adds. 

Yamato explains that the causes or factors related to the development of musculoskeletal pain in children and adolescents are currently unknown. “For that reason, it’s a condition that often can’t be identified through imaging tests but rather mainly based on the patient’s account,” she says. 

She points out that the term “growing pains” leads parents and healthcare professionals to underestimate real, debilitating pain, leaving children with unclear diagnoses and no appropriate treatment protocols. 

“Therefore, the clinical practice guidelines are to reassure families about the good prognosis but to closely monitor those who experience frequent and/or recurrent episodes of pain, with the aim of interrupting the trajectory toward chronic pain in adulthood,” she says. 

Importance of the emotional environment

“Since we found that pain may be connected to other issues, such as sleep quality, psychosomatic symptoms, and family relationship harmony, the emotional environment also emerges as a possible predictor of recovery. Therefore, we suggest that healthcare professionals pay special attention to the quality of life of children and adolescents, moving beyond a purely physical analysis of pain to understand these children’s and adolescents’ life contexts,” she says.  

About São Paulo Research Foundation (FAPESP)
The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at www.fapesp.br/en and visit FAPESP news agency at www.agencia.fapesp.br/en to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at http://agencia.fapesp.br/subscribe

---

Journal

Journal of Orthopaedic and Sports Physical Therapy

DOI

10.2519/jospt.2026.13817 

Article Title

The Prognosis of Disabling Musculoskeletal Pain and Predictors of Recovery in Children

 

New research makes critical discovery for the global fight against antibiotic resistance

Monash University

Facebook

X
WhatsAppEmail

 

image: 

(L-R) Siobhonne Breen, Dominika Fuhs, Cornelia Landersdorfer, with Pseudomonas aeruginosa in a petri dish.

view more 

Credit: Monash University

A Monash University-led study has found that an unusual pairing of two commonly used antibiotics can kill and stop the spread of resistance in a highly drug-resistant bacterium, Pseudomonas aeruginosa, which can cause life-threatening bloodstream infections, pneumonia and meningitis.

Published in The Lancet Microbe, Monash Institute of Pharmaceutical Sciences (MIPS) researchers used a validated laboratory infection system in which they were able to expose bacterial samples from infected patients to simulated antibiotic dosing regimens, as would actually occur in hospitalised patients.

The discovery of the combination regimen of two so-called β-lactam antibiotics – the most commonly used antibiotics class against serious infections – comes in the context of the World Health Organization’s designation of Pseudomonas aeruginosa as a high-priority pathogen requiring rapid and sustained action.

Antimicrobial resistance (AMR) is one of the top global public health threats and was directly responsible for 1.14 million deaths in 2021. The impact of AMR puts many of the gains of modern medicine at risk, including jeopardising procedures and treatments such as surgery, caesarean sections and cancer chemotherapy. 

AMR occurs when bacteria change over time and no longer respond to previously successful antibiotic treatments. Bacteria that develop AMR to several of the commonly used antibiotics can cause infections that are harder to treat, increasing the risk of disease spread, severe illness and death. 

The development of new antibiotics has not kept pace with the rapid rise in AMR, which means some bacteria, such as Pseudomonas aeruginosa, have become resistant to essentially all available antibiotics. 

Co-lead author, Associate Professor Cornelia Landersdorfer from MIPS, said their method was applied to the combination regimen of two β-lactam antibiotics, as well as treatments with each of the antibiotics alone. The combination regimen was very successful, as it resulted in much faster and generally substantially greater killing of bacteria than each antibiotic alone. In addition, the combination regimen very substantially suppressed resistance to both antibiotics.

Subsequently, a mathematical model, utilising quantitative systems pharmacology (QSP), was developed to describe the data from the infection system, and predict likely outcomes in patients. QSP models incorporate biological information, such as genetic information, to describe and predict how medicines work against disease in the human body. 

“The QSP modelling approach coupled with genomic analysis performed in hospitals could represent a step towards optimising and personalising antibiotic regimens against life-threatening infections caused by Pseudomonas aeruginosa,” Associate Professor Landersdorfer said. 

“This research is important because previous approaches to selecting an antibiotic regimen do not account for important pre-existing bacterial characteristics, including mutations, that can influence resistance emergence in bacterial patient isolates of important pathogens such as Pseudomonas aeruginosa.” 

The QSP model in the current study is the first to incorporate information on the various resistance mechanisms present in bacterial samples from infected patients before treatment, and those which emerge during therapy with an antibiotic.

The developed QSP model describes the full time-course of bacterial growth, bacterial killing and emergent antibiotic resistance across multiple Pseudomonas aeruginosa strains isolated from patients. Importantly, the model also incorporates the contributions of various resistance mechanisms, including resistance mutations, to the emergent resistance.

The predictive potential of the novel QSP model developed in the study offers the future possibility of tailoring an antibiotic regimen to the specific resistance and other characteristics of the bacterial strain causing a serious infection in a patient. 

First author, Dr Siobhonne Breen from MIPS said, “resistance of Pseudomonas aeruginosa emerges rapidly even to new antibiotics when used as a single therapy. Therefore, it is important to identify optimal antibiotic combination treatments that maximise killing of the bacteria and suppress the development of further resistance”.

Co-lead author Associate Professor Antonio Oliver from the Instituto de Investigación Sanitaria Illes Balears (IdISBa) and Hospital Son Espases, Palma de Mallorca, Spain said the research indicates that “by identifying resistance characteristics through rapid diagnostics, a therapy adapted to the individual pathogen and infected patient is an exciting future prospect”.

 

Read the research paper: doi.org/10.1016

 

ASSETS AVAILABLE

Images available here.

For more experts, news, opinion and analysis, visit Monash News.

---

Journal

The Lancet Microbe

DOI

10.1016/j.lanmic.2026.101364 

Method of Research

Experimental study

Subject of Research

Cells

Article Title

Dual β-lactam therapy against high-risk Pseudomonas aeruginosa isolates: a dynamic in-vitro infection model study integrating population genomics with quantitative systems pharmacology modelling and simulations

Article Publication Date

25-Jun-2026

COI Statement

AO has received grants and speaker fees from MSD, Pfizer, and Shionogi. All other authors declare no competing interests.

 

Could a dog’s skull shape tell us something about a spinal condition?

Cornell University

Facebook

XLinkedInWeChatBlueskyMessageWhatsAppEmail

ITHACA, N.Y. – A new Cornell University study helps deepen the understanding of skull shapes within different sized dogs and draws a link between cranial and facial shapes, body weight and the risk of syringomyelia, a spinal condition common in some dog breeds.

“We wanted to better characterize what happens to skull shape when you shrink dogs down, so we don’t misdiagnose normal findings as pathologic processes,” said Dr. Peter Scrivani, professor of clinical sciences and corresponding author of the study.

The researchers reviewed the medical records of 852 dogs of varying breeds who had received CT scans of their heads and did not have a known cranial disease.

“This study provides strong evidence that when dogs get smaller, they don’t reduce in size proportionately or isometrically, they actually have a recognizable shape change, which is allometric scaling,” Scrivani said. “We’re not just looking at a miniature wolf-like skull. We’re actually seeing that as the dog shrinks, the cranium undergoes ballooning of the vault that holds the brain, creating a rounder shape.”

Similar shape changes are observed in dogs with altered fluid balance in the central nervous system like hydrocephalus and syringomyelia, a painful condition in which fluid-filled cavities form in the spinal cord. The data showed that breeds predisposed to syringomyelia have a high cranial index. The condition is most common in breeds such as Cavalier King Charles spaniels, Affenpinschers, Brussels Griffons, Chihuahuas and Pomeranians.

“For every 2.2 pounds of body weight that you reduce, there’s a 25% increase in the risk of being in a group that’s going to get syringomyelia,” Scrivani said, “and the shorter and wider the cranium is, the higher risk you have of being in that group.”

Further research is needed to understand if bony changes to the cranium and face contribute to syringomyelia or are a consequence of the disease process, Scrivani said. That understanding could inform treatment and breeding strategies.

“This is a study on associations,” he said. “We don’t prove cause and effect, but we identify things that may be related, or that are related, at least statistically, and then we provided different possibilities for why these associations may have been observed.”

For additional information, see this Cornell Chronicle story.

Cornell University has dedicated television and audio studios available for media interviews.

-30-

---

Journal

Veterinary Radiology & Ultrasound

DOI

10.1111/vru.70178 

Article Title

Miniaturization in Domestic Dogs: Relationships Among Cranial Shape, Head Indexes, and Body Weight