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Background <p>Maternal hypertensive disorders (MHD) are a leading cause of maternal and fetal mortality, with profound short- and long-term public health impacts. MHD epidemiology remains poorly controlled, and the incidence rate has shown an increase over the past few decades. Therefore, a comprehensive assessment of global burden and prevalence inequalities holds considerable significance for optimizing public health strategies.</p> Methods <p>The global burden and epidemic trend of MHD from 1990 to 2021 were investigated, and the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were examined utilizing the Global Burden of Disease (GBD). The trends were stratified by age and socio-demographic index (SDI), and further analysis was performed to delve into the correlation between SDI and incidence, prevalence, mortality, and DALYs. Additionally, a Bayesian Age-Period Cohort (BAPC) model was constructed to predict the burden of disease in MHD from 2022 to 2046.</p> Results <p>The DALYs induced by MHD decreased significantly from 3.48 million (95% UI, 3.09–3.87 million) in 1990 to 2.47 million (95% UI, 2.08–2.96 million) in 2021, involving an Excess Annual Percentage Change (EAPC) of -2.10. Both the age-standardized DALYs rate (ASDR, AAPC = -2.11) and the age-standardized incidence rate (ASIR, AAPC = -0.60) exhibited evident decreasing trends. The ASDRs of all the age-stratified subgroups decreased as well. Notably, the largest declines were observed in the 20–24 age group with an EAPC of -2.39 (95% UI: -2.56, -2.23). The ASIR exhibited an obvious negative correlation with SDI, and the inequality tended to shrink. Projections for 2046 indicate that global ASDR and ASIR are expected to sustain their downward trajectory. Globally, ASDR in MHD linked to iron deficiency decreased significantly (EAPC = -2.03), with High-middle SDI countries experiencing particularly steep reductions (EAPC = -4.25).</p> Conclusions <p>This study performed a comprehensive analysis of the global burden of MHD and observed regional and national inequalities. The investigation also identified a correlation between MHD and SDI, and most regions exhibited an overall declining trend in disease burden. However, further investigations should still be conducted to assist the establishment of public health strategies for MHD prevention.</p>

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Global, regional, and national burden, trends, and inequality analysis of maternal hypertensive disorders (MHD) from 1990 to 2021, and predictions to 2046

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  • 发表日期：

    2025年7月2日

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  • Junde Zhao,
  • Ruiting Gong,
  • Xiaohui Sui,
  • Zuocheng Wang,
  • Xiaotao Bian,
  • Yiider Tseng

摘要

Background

Maternal hypertensive disorders (MHD) are a leading cause of maternal and fetal mortality, with profound short- and long-term public health impacts. MHD epidemiology remains poorly controlled, and the incidence rate has shown an increase over the past few decades. Therefore, a comprehensive assessment of global burden and prevalence inequalities holds considerable significance for optimizing public health strategies.

Methods

The global burden and epidemic trend of MHD from 1990 to 2021 were investigated, and the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were examined utilizing the Global Burden of Disease (GBD). The trends were stratified by age and socio-demographic index (SDI), and further analysis was performed to delve into the correlation between SDI and incidence, prevalence, mortality, and DALYs. Additionally, a Bayesian Age-Period Cohort (BAPC) model was constructed to predict the burden of disease in MHD from 2022 to 2046.

Results

The DALYs induced by MHD decreased significantly from 3.48 million (95% UI, 3.09–3.87 million) in 1990 to 2.47 million (95% UI, 2.08–2.96 million) in 2021, involving an Excess Annual Percentage Change (EAPC) of -2.10. Both the age-standardized DALYs rate (ASDR, AAPC = -2.11) and the age-standardized incidence rate (ASIR, AAPC = -0.60) exhibited evident decreasing trends. The ASDRs of all the age-stratified subgroups decreased as well. Notably, the largest declines were observed in the 20–24 age group with an EAPC of -2.39 (95% UI: -2.56, -2.23). The ASIR exhibited an obvious negative correlation with SDI, and the inequality tended to shrink. Projections for 2046 indicate that global ASDR and ASIR are expected to sustain their downward trajectory. Globally, ASDR in MHD linked to iron deficiency decreased significantly (EAPC = -2.03), with High-middle SDI countries experiencing particularly steep reductions (EAPC = -4.25).

Conclusions

This study performed a comprehensive analysis of the global burden of MHD and observed regional and national inequalities. The investigation also identified a correlation between MHD and SDI, and most regions exhibited an overall declining trend in disease burden. However, further investigations should still be conducted to assist the establishment of public health strategies for MHD prevention.