Global burden of pulmonary arterial hypertension in infants under 1 year, 1990–2023, and projections to 2040: a GBD 2023 analysis

Using GBD 2023 data, we updated the global burden of infant PAH (1990–2023) and analyzed incidence, disability-adjusted life years (DALYs), and mortality by region, sex, age, and sociodemographic index (SDI). Trends were analyzed via joinpoint/log-linear regression, with ARIMA forecasting to 2040. The incidence remained stable (0.18 per 100,000, EAPC −0.04%), while DALYs and mortality declined (EAPCs −3.40%, −5.36%). Improvements were unequal: high-SDI regions fell most, and low-SDI regions experienced increasing cases and the slowest DALY reduction. India had the highest number of cases/deaths, and Afghanistan had the highest DALY rate. In half of the patients, mortality peaked at 6–11 months. The incidence of mortality was slightly greater for girls than for boys, and boys had greater DALYs/mortality. Projections to 2040 show persistent burden (DALYs 49.29, mortality 0.52 per 100,000) and unchanged sex disparities. Despite overall progress, socioeconomic inequalities remain. The stable incidence and increasing low-resource burden call for targeted, equitable interventions focusing on low-SDI countries, the perinatal period, and new-born males.