Xu Tongtong, Dong Chenxian, Shao Jianjiang, Huo Chaojing, Chen Zuhai, Shi Zhengyang, Yao Teng, Gu Chenyang, Wei Wanting, Rui Dongsheng, Li Xiaoju, Hu Yunhua, Ma Jiaolong, Niu Qiang, Yan Yizhong
Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China.
Front Nutr. 2024 Feb 15;11:1343772. doi: 10.3389/fnut.2024.1343772. eCollection 2024.
Maternal malnutrition is a major global public health problem that can lead to serious maternal diseases. This study aimed to analyze and predict the spatio-temporal trends in the burden of maternal disorders attributable to malnutrition, and to provide a basis for scientific improvement of maternal malnutrition and targeted prevention of maternal disorders.
Data on maternal disorders attributable to malnutrition, including number of deaths, disability-adjusted life years (DALYs), population attributable fractions (PAFs), age-standardized mortality rates (ASMRs), and age-standardized DALY rates (ASDRs) were obtained from the Global Burden of Disease Study 2019 to describe their epidemiological characteristics by age, region, year, and type of disease. A log-linear regression model was used to calculate the annual percentage change (AAPC) of ASMR or ASDR to reflect their temporal trends. Bayesian age-period-cohort model was used to predict the number of deaths and mortality rates to 2035.
Global number of deaths and DALYs for maternal disorders attributable to malnutrition declined by 42.35 and 41.61% from 1990 to 2019, with an AAPC of -3.09 (95% CI: -3.31, -2.88) and -2.98 (95% CI: -3.20, -2.77) for ASMR and ASDR, respectively. The burden was higher among younger pregnant women (20-29 years) in low and low-middle socio-demographic index (SDI) regions, whereas it was higher among older pregnant women (30-39 years) in high SDI region. Both ASMR and ASDR showed a significant decreasing trend with increasing SDI. Maternal hemorrhage had the highest burden of all diseases. Global deaths are predicted to decline from 42,350 in 2019 to 38,461 in 2035, with the ASMR declining from 1.08 (95% UI: 0.38, 1.79) to 0.89 (95% UI: 0.47, 1.31).
Maternal malnutrition is improving globally, but in the context of the global food crisis, attention needs to be paid to malnutrition in low SDI regions, especially among young pregnant women, and corresponding measures need to be taken to effectively reduce the burden of disease.
孕产妇营养不良是一个重大的全球公共卫生问题，可导致严重的孕产妇疾病。本研究旨在分析和预测营养不良所致孕产妇疾病负担的时空趋势，为科学改善孕产妇营养不良及针对性预防孕产妇疾病提供依据。
从《2019年全球疾病负担研究》中获取营养不良所致孕产妇疾病的数据，包括死亡人数、伤残调整生命年（DALYs）、人群归因分数（PAFs）、年龄标准化死亡率（ASMRs）和年龄标准化DALY率（ASDRs），以按年龄、地区、年份和疾病类型描述其流行病学特征。使用对数线性回归模型计算ASMR或ASDR的年度百分比变化（AAPC），以反映其时间趋势。采用贝叶斯年龄-时期-队列模型预测到2035年的死亡人数和死亡率。
1990年至2019年，全球营养不良所致孕产妇疾病的死亡人数和DALYs分别下降了42.35%和41.61%，ASMR和ASDR的AAPC分别为-3.09（95%CI：-3.31，-2.88）和-2.98（95%CI：-3.20，-2.77）。在社会人口学指数（SDI）较低和中低的地区，年轻孕妇（20-29岁）的负担较高，而在高SDI地区，年龄较大的孕妇（30-39岁）的负担较高。随着SDI的增加，ASMR和ASDR均呈显著下降趋势。孕产妇出血在所有疾病中负担最高。预计全球死亡人数将从2019年的42350人降至2035年的38461人，ASMR从1.08（95%UI：0.38，1.79）降至0.89（95%UI：0.47，1.31）。
全球孕产妇营养不良状况正在改善，但在全球粮食危机的背景下，需要关注低SDI地区的营养不良问题，尤其是年轻孕妇，并采取相应措施有效减轻疾病负担。
