Rising global burden of common gynecological diseases in women of childbearing age from 1990 to 2021: an update from the Global Burden of Disease Study 2021.

BACKGROUND

Gynecological diseases significantly impact the reproductive health in women of childbearing age (WCBA). However, there is currently a lack of analysis on the specific burden and forecast of common gynecological diseases for this population. The aim of this study was to provide new details for gynecological disorders in WCBA from 1990 to 2021 worldwide based on the Global Burden of Disease (GBD) data.

METHODS

Employing data from the GBD 2021, we analyzed the disability-adjusted life years (DALYs), death, incidence, and prevalence for thirteen types of gynecological disorders by socioeconomic development index (SDI), age, year, and location in WCBA. Age-standardized rates were used to compare the burdens across various time periods and locations. Temporal trends were assessed using Joinpoint regression analysis from 1990 to 2021, the Bayesian age-period-cohort (BAPC) model projected the disease burden through 2031, and the Nordpred model conducted a sensitivity analysis of the prediction results, which validated the findings' reliability.

RESULTS

From 1990 to 2021, the age-standardized DALYs rate (ASDR) and mortality rate (ASMR) of combined gynecological diseases (CGDs) increased by AAPC of 0.28% (95% CI 0.19 to 0.36) and 0.53% (95% CI 0.25 to 0.82) among WCBA. Furthermore, the projections showed a declining trend in the next decade, with ASDR and ASMR dropping by 11.06% and 25.23%, respectively. Notably, HIV/AIDS, polycystic ovary syndrome (PCOS), infertility, premenstrual syndrome (PMS) were the key drivers behind the increased ASDR of CGDs. In 2021, HIV/AIDS (16.38 million), PMS (7.43 million), and cervical cancer (4.18 million) topped the list for the absolute number of DALYs globally among WCBA. CGDs burdens were negatively correlated with and SDI. Women aged 15-24 years showed the most significant rise in CGDs burdens, highlighting its increasingly affecting younger women. The DALYs and death of malignant gynecological tumors are most significant in women aged 40-49 years, the incidence of PCOS predominantly occurs in 15-19 years, and infertility prevalence peaks at 30-39 years.

CONCLUSIONS

The global CGDs burden has increased over the last 32 years, and higher in lower SDI countries. Immediate and effective interventions should be taken to target different types of gynecological disorders, age groups, and countries with high gynecological disease burdens. These findings would provide targeted insights for public health policies and interventions enhancing reproductive health in women of childbearing age.