目的 分析1990—2023年中国早产的疾病负担趋势与性别差异，并预测未来走向，为防控策略提供依据。 方法 基于2023年全球疾病负担（Global Burden of Disease, GBD）数据库，分析1990—2023年中国早产的发病率、死亡率与伤残调整生命年（disability⁃adjusted life year, DALY）率的趋势，并采用Joinpoint回归模型识别趋势转折点，应用灰色GM（1，1）模型预测未来发病率。 结果 2023年，中国早产发病64.5万例，死亡0.6万例，DALY为133.0万人年。与1990年相比，早产的发病率、年龄标准化死亡率和年龄标准化DALY率分别下降31.3%、91.4%与87.2%。趋势分析显示，早产的发病率下降自2001年后明显放缓，DALY率在2020—2023年间下降显著减弱。1990—2023年间，中国男性早产的发病率、年龄标准化死亡率及年龄标准化DALY率均持续高于女性。GM（1，1）模型预测显示，2024—2040年中国早产的发病率将缓慢下降，由7 172.6/10万降至6 999.3/10万。 结论 中国早产疾病负担长期下降，但近期趋缓，未来数年将保持缓慢下降趋势，男性负担持续高于女性。

Objective To study the trends and sex differences in the disease burden of preterm birth in China from 1990 to 2023, and to predict its future trajectory to inform prevention and control strategies. Methods Data from the Global Burden of Disease 2023 database were used to assess trends in incidence, mortality, and disability-adjusted life year (DALY) rates of preterm birth from 1990 to 2023. Joinpoint regression analysis was used to identify turning points in the temporal trends, and a GM(1,1) model was applied to forecast future incidence rates. Results In 2023, there were 645 000 preterm births and 6 000 deaths in China, resulting in 1.33 million DALYs. Compared with 1990, the incidence rate, age-standardized mortality rate, and age-standardized DALY rate decreased by 31.3%, 91.4%, and 87.2%, respectively. The decline in the incidence rate slowed notably after 2001, and the decline in the DALY rate weakened during 2020-2023. From 1990 to 2023, males in China consistently had higher incidence rate, age-standardized mortality rate, and age-standardized DALY rate of preterm birth than females. The GM(1,1) model predicts that the incidence rate of preterm birth will decline slowly from 7 172.6 per 100 000 in 2024 to 6 999.3 per 100 000 in 2040. Conclusions The disease burden of preterm birth in China shows a long-term decline, but the pace has recently slowed; over the next few years it is expected to remain on a slow downward trajectory, with a persistently higher burden in males than in females.