Low Birth Weight as a Risk Factor for Neonatal Preterm Mortality in the Middle East and North Africa Region: A Regional Trend Analysis

Background: Low birth weight (LBW) is a well-established risk factor for neonatal mortality, particularly among preterm infants. However, regional trends and the burden of LBW-related neonatal deaths remain underexplored in the Middle East and North Africa (MENA) region. This study examines the trends in LBW-related preterm neonatal mortality across 21 MENA countries during 1990–2021. Aims: This study aims to assess the temporal trends and geographic disparities in LBW-related preterm neonatal mortality across 21 MENA countries from 1990 to 2021, using data from the Global Burden of Disease (GBD) database, to identify high-burden countries and inform targeted public health interventions. Methodology: Data from the GBD database were analyzed for 21 MENA countries, covering 1990–2021. A Bayesian dynamic model was applied to evaluate temporal changes and geographic patterns across the included countries. Results: Yemen and Sudan exhibited the highest positive deviations, with mortality burdens 213.4% and 207.8% above the regional trend, respectively ( P < 0.05). In contrast, Qatar, Bahrain, and Kuwait showed the most substantial negative deviations, with burdens 60.3%, 56.0%, and 55.0% below the regional average, respectively ( P < 0.05). Some countries, including Egypt, Jordan, Lebanon, and Tunisia, revealed no statistically significant deviation from the regional trend. Conclusion: While overall LBW-related neonatal mortality has declined in the MENA region, substantial disparities remain between countries. Targeted public health interventions are necessary, particularly in high-burden countries such as Yemen and Sudan, to reduce preterm neonatal mortality. These findings provide evidence to guide policy and prioritize resources to improve neonatal health outcomes across the region.