Guo Zhifeng, Ji Wangquan, Yan Mengqing, Shi Yang, Chen Teng, Bai Fanghui, Wu Yu, Guo Zhe, Song Linlin
Nanyang Maternal and Child Health Care Hospital, Nanyang Central Hospital, Nanyang, China.
College of Public Health, Zhengzhou University, Zhengzhou, China.
Paediatr Perinat Epidemiol. 2025 Feb;39(2):135-145. doi: 10.1111/ppe.13156. Epub 2024 Dec 10.
Maternal obstructed labour and uterine rupture (MOLUR) are among the major maternal labour complications that threaten maternal and child health.
The objective of this study was to systematically analyse the global burden of MOLUR using the Global Burden of Disease 2021 (GBD 2021) database to inform further improvements in maternal-related public health policies.
Incidence and disability-adjusted life-year (DALY) data on MOLUR from 1990 to 2021 were collected in the GBD 2021. The joinpoint and Bayesian age-period-cohort models were used to analyse and predict time burden trends. The slope index and concentration index were used to evaluate health inequality. Frontier analysis was used to visualise the potential for burden reduction in individual countries or territories.
In 2021, 13,471,093 (95% uncertainty interval [UI] 8,938,373, 19,008,282) incident cases of MOLUR were reported worldwide, which caused 1,067,270 (95% UI 896,161, 1,275,042) DALYs. Over the past three decades, there has been an overall downward trend in the age-standardised incidence rate (ASIR) and age-standardised DALY rate (ASDR) of MOLUR globally, with the ASIR decreasing from 554.0 (95% UI 355.6, 786.3) per 100,000 in 1990 to 347.0 (95% UI 228.8, 489.4) in 2021. The ASDR decreased from 65.4 (95% UI 56.0, 75.7) per 100,000 in 1990 to 27.0 (95% UI 22.7, 32.2) in 2021. By 2040, the global ASIRs and ASDRs projections for MOLUR will likely continue to decline. Socioeconomic-related inequalities are narrowing, but the burden remains concentrated in low socioeconomically developed countries. Israel and Afghanistan showed the largest differences from the frontier boundaries of ASIR and ASDR.
Although the global burden of MOLUR has declined in the last three decades, it remains high and is still concentrated in economically underdeveloped countries. The reduction in DALYs attributable to MOLUR globally reflects significant progress in improving maternal health and reducing complications of childbirth.
孕产妇梗阻性分娩和子宫破裂（MOLUR）是威胁母婴健康的主要孕产妇分娩并发症。
本研究的目的是利用《2021年全球疾病负担》（GBD 2021）数据库系统分析MOLUR的全球负担，为进一步改进孕产妇相关公共卫生政策提供依据。
在GBD 2021中收集了1990年至2021年期间MOLUR的发病率和伤残调整生命年（DALY）数据。采用连接点和贝叶斯年龄-时期-队列模型分析和预测时间负担趋势。采用斜率指数和集中指数评估健康不平等。采用前沿分析直观呈现各个国家或地区减轻负担的潜力。
2021年，全球报告了13471093例（95%不确定区间[UI]为8938373，19008282）MOLUR发病病例，导致1067270例（95% UI为896161，1275042）DALYs。在过去三十年中，全球MOLUR的年龄标准化发病率（ASIR）和年龄标准化DALY率（ASDR）总体呈下降趋势，ASIR从1990年的每10万人554.0例（95% UI为355.6，786.3）降至2021年的347.0例（95% UI为228.8，489.4）。ASDR从1990年的每10万人65.4例（95% UI为56.0，75.7）降至2021年的27.0例（95% UI为22.7，32.2）。到2040年，全球MOLUR的ASIR和ASDR预测可能会继续下降。社会经济相关不平等正在缩小，但负担仍集中在社会经济欠发达国家。以色列和阿富汗在ASIR和ASDR前沿边界方面的差异最大。
尽管在过去三十年中MOLUR的全球负担有所下降，但仍然很高，并且仍然集中在经济欠发达国家。全球因MOLUR导致的DALYs减少反映了在改善孕产妇健康和减少分娩并发症方面取得的重大进展。
