Global Temporal Trends and Projections of Stroke Among Women of Childbearing Age: An Age-Period-Cohort Analysis Based on the Global Burden of Disease Study 2021.

BACKGROUND

Stroke is a major global health concern, particularly for women of childbearing age (WCBA), who face unique biological and sociodemographic risks. This study analyzes temporal trends in stroke incidence, prevalence, disability-adjusted life-year (DALY), and deaths among WCBA at global, regional, and national levels over the past three decades, using age-period-cohort (APC) modeling.

METHODS

Stroke burden data for WCBA from 1992 to 2021 across 204 countries were extracted from the Global Burden of Disease (GBD) 2021 study. An APC model assessed annual percentage changes in stroke burden (net drift), age group-specific trends (local drift), and relative risks associated with age, period, and cohort factors. Future stroke burden was projected using Bayesian APC models through 2030.

RESULTS

From 1992 to 2021, global stroke incidence cases among WCBA increased from 638,478 to 779,371, but ASIR and AS-DALYs declined. High-SDI regions consistently had the lowest stroke rates, while middle- and low-SDI regions, particularly China and India, accounted for a significant portion of global cases. Despite declines in some regions, countries like the Philippines and Pakistan exhibited rising trends. Projections to 2030 indicate a continued increase in stroke incidence cases, with higher rates expected in middle-income countries due to emerging risk factors like obesity and gestational diabetes.

CONCLUSIONS

While ASIR and AS-DALYs declined globally, rising incidence case numbers and persistent disparities highlight the need for targeted prevention and policy strategies, particularly in low- and middle-income regions, to reduce the stroke burden among WCBA.