Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Public Health. 2024 Oct 23;12:1428271. doi: 10.3389/fpubh.2024.1428271. eCollection 2024.
Maternal sepsis and other maternal infections (MSMIs) are major public health concerns worldwide. However, comprehensive data on their global burden and evolving trends remain sparse. This study aims to explore the epidemiological trends of MSMIs in women of childbearing age (WCBA) from 1990 to 2019, investigate the relationship between disease burden and age, period, and birth cohorts, and then provide a prediction of MSMIs incidence and deaths.
The estimates and 95% uncertainty intervals (UIs) for the incidence and death number of MSMIs in seven age groups (15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49 years) were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The age-standardized incidence and mortality rates of MSMIs in WCBA were estimated utilizing the age standardization by direct method. Joinpoint regression analysis was employed to investigate the changing trends of age-standardized incidence and mortality rates from 1990 to 2019. Age-period-cohort analysis was utilized to estimate the independent effects of age, period, and birth cohorts. Furthermore, a Nordpred age-period-cohort analysis was implemented to predict the global epidemiological trends through 2044.
In 2019, the estimated global age-standardized incidence and mortality rates of MSMIs in WCBA were 1072.90 (95% UI: 725.93 to 1483.46) and 0.86 (95% UI: 0.69 to 1.05), respectively. The highest disease burden existed in the African Region. From 1990 to 2019, the estimated global age-standardized incidence and mortality rates of MSMIs (AAPC: -1.32, 95% CI: -1.34 to -1.30; AAPC: -3.39, 95% CI: -4.28 to -2.48) in WCBA both demonstrated significant declining trends. The changing trends varied significantly across 6 regions and 204 countries. The effects of age, period, and cohort on incidence and mortality rates differed. From 2020 to 2044, the global age-standardized incidence rate of MSMIs in WCBA was predicted to decrease whereas the case number increases slowly.
The global trends in MSMIs incidence and mortality generally showed a decline with considerable heterogeneity, indicating both the effectiveness and unevenness of global management of MSMIs. Moreover, the predicted increased case number highlights prominent challenges in the control of MSMIs.
孕产妇脓毒症和其他孕产妇感染（MSMIs）是全球主要的公共卫生问题。然而，关于其全球负担和演变趋势的综合数据仍然很少。本研究旨在探讨 1990 年至 2019 年育龄妇女（WCBA）中 MSMIs 的流行病学趋势，研究疾病负担与年龄、时期和出生队列之间的关系，然后对 MSMIs 的发病率和死亡率进行预测。
从全球疾病、伤害和危险因素研究（GBD）2019 中获得了七个年龄组（15-19、20-24、25-29、30-34、35-39、40-44、45-49 岁）中 MSMIs 的发病率和死亡人数的估计值和 95%不确定区间（UI）。利用直接法对 WCBA 中 MSMIs 的年龄标准化发病率和死亡率进行了估计。采用 Joinpoint 回归分析研究了 1990 年至 2019 年年龄标准化发病率和死亡率的变化趋势。采用年龄-时期-队列分析估计了年龄、时期和出生队列的独立影响。此外，还进行了 Nordpred 年龄-时期-队列分析，以预测到 2044 年的全球流行病学趋势。
2019 年，估计全球 WCBA 中 MSMIs 的年龄标准化发病率和死亡率分别为 1072.90（95%UI：725.93 至 1483.46）和 0.86（95%UI：0.69 至 1.05）。疾病负担最高的地区是非洲地区。1990 年至 2019 年，全球 WCBA 中 MSMIs 的年龄标准化发病率和死亡率（AAPC：-1.32，95%CI：-1.34 至-1.30；AAPC：-3.39，95%CI：-4.28 至-2.48）均呈显著下降趋势。变化趋势在 6 个地区和 204 个国家之间存在显著差异。年龄、时期和队列对发病率和死亡率的影响不同。2020 年至 2044 年，全球 WCBA 中 MSMIs 的年龄标准化发病率预计会下降，而病例数将缓慢增加。
MSMIs 发病率和死亡率的全球趋势总体呈下降趋势，但存在较大的异质性，表明全球对 MSMIs 的管理既有效又不均衡。此外，预测的病例数增加凸显了 MSMIs 控制方面的突出挑战。
