Sex differences in early and late neonatal all-cause mortality and disease burden in Kazakhstan, 2010–2023: A population-based analysis of Global Burden of Disease estimates
4 affiliations
- 1Department of Family Medicine No. 3, Astana Medical University, Astana, Kazakhstan
- 2Department of Children’s Diseases No. 1, Astana Medical University, Astana, Kazakhstan
- 3Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, United States of America
- 4Department of Research Management, JSC Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
Abstract
Background: Neonatal mortality remains a major contributor to child mortality globally, with the greatest burden concentrated in the early neonatal period. Sex differences in neonatal survival are consistently reported, yet population-level evidence on sex-specific patterns of all-cause burden across neonatal subperiods in Central Asia remains limited. This study aimed to quantify temporal trends and sex differences in early (0–6 days) and late (7–27 days) neonatal all-cause mortality and disease burden in Kazakhstan from 2010 to 2023, and to examine projected trajectories to 2030. Methods: We conducted a population-based time-trend study using Global Burden of Disease 2023 estimates for Kazakhstan. Outcomes included mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs), expressed as age-specific rates per 100,000 person-years within the corresponding neonatal age interval. Analyses were stratified by sex and neonatal subperiod. Temporal patterns were described, and sex differences were assessed using comparative rates. Log-linear models were used to estimate projected trends to 2030. National mortality statistics were used for external trend consistency. Results: Neonatal mortality and DALY rates declined between 2010 and 2023 in both early and late neonatal periods, with substantially higher rates observed in the early neonatal period. Across all years, males consistently exhibited higher mortality, YLLs, and DALYs than females in both neonatal subperiods; YLD rates followed a different pattern, being modestly higher among females in the early-neonatal period but nearly equal between sexes in the late-neonatal period. YLLs accounted for the vast majority of DALYs, indicating that mortality rather than non-fatal disability drives neonatal burden. Projections suggest continued declines through 2030, male point estimates for mortality and DALYs remained higher than female estimates throughout, although the magnitude of this difference narrowed substantially and became statistically uncertain in the most recent years, with rate-ratio uncertainty intervals spanning or approaching unity. Conclusions: Despite substantial reductions in neonatal mortality in Kazakhstan, male point estimates for mortality and burden remained higher than female estimates throughout the study period, although this difference narrowed substantially and became uncertain in recent years; mortality remained heavily concentrated in the early neonatal period. These findings highlight persistent, though narrowing, epidemiologic inequalities within improving population health trends.
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BibTeX
@article{tsay2026differences,
title = {{Sex differences in early and late neonatal all-cause mortality and disease burden in Kazakhstan, 2010–2023: A population-based analysis of Global Burden of Disease estimates}},
author = {Yelena Tsay and Bekzhan Namet and Saltanat Urazova and Nazym Galimgozhina and Lyailyum Saparova and Nazym Amanbayeva and Madina Syzdykova and Yuliya Ganzhula and Isida Ashirmatova and Gulnur Ashirova and Indira Karibayeva},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0347911},
url = {https://doi.org/10.1371/journal.pone.0347911},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Sex differences in early and late neonatal all-cause mortality and disease burden in Kazakhstan, 2010–2023: A population-based analysis of Global Burden of Disease estimates
AU - Yelena Tsay
AU - Bekzhan Namet
AU - Saltanat Urazova
AU - Nazym Galimgozhina
AU - Lyailyum Saparova
AU - Nazym Amanbayeva
AU - Madina Syzdykova
AU - Yuliya Ganzhula
AU - Isida Ashirmatova
AU - Gulnur Ashirova
AU - Indira Karibayeva
PY - 2026
DA - 2026/10/08
JO - PLOS One
DO - 10.1371/journal.pone.0347911
UR - https://doi.org/10.1371/journal.pone.0347911
AB - Background: Neonatal mortality remains a major contributor to child mortality globally, with the greatest burden concentrated in the early neonatal period. Sex differences in neonatal survival are consistently reported, yet population-level evidence on sex-specific patterns of all-cause burden across neonatal subperiods in Central Asia remains limited. This study aimed to quantify temporal trends and sex differences in early (0–6 days) and late (7–27 days) neonatal all-cause mortality and disease burden in Kazakhstan from 2010 to 2023, and to examine projected trajectories to 2030. Methods: We conducted a population-based time-trend study using Global Burden of Disease 2023 estimates for Kazakhstan. Outcomes included mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs), expressed as age-specific rates per 100,000 person-years within the corresponding neonatal age interval. Analyses were stratified by sex and neonatal subperiod. Temporal patterns were described, and sex differences were assessed using comparative rates. Log-linear models were used to estimate projected trends to 2030. National mortality statistics were used for external trend consistency. Results: Neonatal mortality and DALY rates declined between 2010 and 2023 in both early and late neonatal periods, with substantially higher rates observed in the early neonatal period. Across all years, males consistently exhibited higher mortality, YLLs, and DALYs than females in both neonatal subperiods; YLD rates followed a different pattern, being modestly higher among females in the early-neonatal period but nearly equal between sexes in the late-neonatal period. YLLs accounted for the vast majority of DALYs, indicating that mortality rather than non-fatal disability drives neonatal burden. Projections suggest continued declines through 2030, male point estimates for mortality and DALYs remained higher than female estimates throughout, although the magnitude of this difference narrowed substantially and became statistically uncertain in the most recent years, with rate-ratio uncertainty intervals spanning or approaching unity. Conclusions: Despite substantial reductions in neonatal mortality in Kazakhstan, male point estimates for mortality and burden remained higher than female estimates throughout the study period, although this difference narrowed substantially and became uncertain in recent years; mortality remained heavily concentrated in the early neonatal period. These findings highlight persistent, though narrowing, epidemiologic inequalities within improving population health trends.
SN - 1932-6203
ER -