Hu Qilin, Wang Lvming, Chen Qianmin, Wang Zhiping
Xuzhou Medical University, Xuzhou, 221000, China.
Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou, 221000, China.
BMC Pregnancy Childbirth. 2025 Mar 14;25(1):285. doi: 10.1186/s12884-025-07409-2.
Maternal sepsis and other maternal infections (MSMIs) significantly contribute to maternal morbidity and mortality worldwide, posing critical challenges due to their rapid progression and severe outcomes.
Data from the Global Burden of Disease (GBD) 2021 study, covering 204 countries and territories, were used to evaluate the incidence, death, and disability-adjusted life years (DALYs) of MSMI. Statistical methods included joinpoint regression, age-period-cohort analysis, decomposition analysis, frontier analysis, and ARIMA model forecasting.
From 1990 to 2021, global MSMI incidence decreased from 22.45 million to 19.05 million, with the age-standardized rate (ASR) dropping from 764.03 (95% UI: 573.01-970.54) to 494.19 (95% UI: 377.34-623.90) per 100,000 people. High-SDI regions saw significant reductions, while low-SDI regions experienced increases. Women aged 20-24 consistently had the highest incidence, death, and DALYs. Iron deficiency was a significant risk factor, especially in lower SDI regions. Decomposition analysis showed that epidemiological changes and population growth were major drivers, particularly in low-SDI regions. Age-period-cohort analysis revealed women aged 20-29 as the most vulnerable, with notable improvements after 2000 and progressively decreasing risks in younger cohorts. Frontier analysis revealed that higher-SDI countries had greater improvement potential. ARIMA forecasting suggests continued declines in MSMI cases and ASR through 2040.
While significant progress has been made globally, challenges persist, including rising incidence in low-SDI regions, vulnerability of women aged 20-29, and the impact of iron deficiency. Efforts to address these and improve healthcare infrastructure are critical to further reduce MSMI and enhance maternal health outcomes.
孕产妇败血症和其他孕产妇感染（MSMI）在全球范围内对孕产妇发病和死亡有重大影响，因其进展迅速和后果严重而带来严峻挑战。
利用全球疾病负担（GBD）2021研究中涵盖204个国家和地区的数据，评估MSMI的发病率、死亡率和伤残调整生命年（DALY）。统计方法包括连接点回归、年龄-时期-队列分析、分解分析、前沿分析和自回归积分移动平均（ARIMA）模型预测。
1990年至2021年，全球MSMI发病率从2245万例降至1905万例，年龄标准化率（ASR）从每10万人764.03（95%不确定区间：573.01 - 970.54）降至494.19（95%不确定区间：377.34 - 623.90）。高社会人口指数（SDI）地区有显著下降，而低SDI地区有所上升。20 - 24岁的女性发病率、死亡率和DALY一直最高。缺铁是一个重要风险因素，尤其是在低SDI地区。分解分析表明，流行病学变化和人口增长是主要驱动因素，特别是在低SDI地区。年龄-时期-队列分析显示，20 - 29岁的女性最易受影响，2000年后有显著改善，年轻队列中的风险逐渐降低。前沿分析表明，高SDI国家有更大的改善潜力。ARIMA预测表明，到2040年MSMI病例数和ASR将持续下降。
虽然全球已取得重大进展，但挑战依然存在，包括低SDI地区发病率上升、20 - 29岁女性的脆弱性以及缺铁的影响。应对这些问题并改善医疗保健基础设施的努力对于进一步降低MSMI和改善孕产妇健康结局至关重要。
