Cao Jianghong, Xue Dongdong, Gao Dan, Zhang Gangli
The Intensive Care Unit Department of Shanxi Provincial People Hospital, Shanxi Medical University, Taiyuan, 030001, China.
The Neurosurgery Department of Shanxi Provincial People Hospital, Shanxi Medical University, Taiyuan, 030001, China.
BMC Pregnancy Childbirth. 2025 May 26;25(1):612. doi: 10.1186/s12884-025-07722-w.
Maternal sepsis and other maternal infections (MSMIs) pose significant global health challenges, leading to considerable morbidity and mortality. Understanding the global burden of MSMIs is essential for resource allocation and the development of targeted prevention and treatment strategies.
To analyse the global burden of MSMIs from 1990 to 2021, and identify disparities across age groups, regions, countries, and socio-demographic indexes (SDIs).
Data were sourced from the Global Burden of Disease Study (GBD) 2021, stratified by age, SDI level, region, and country. The age-standardized incidence and death rates in 2021, along with their estimated annual percentage changes (EAPCs) from 1990 to 2021, were used to measure the current burden and temporal trends.
In 2021, the numbers of MSMIs incidence and deaths were estimated at 19.05 million (95% [uncertainty interval] UI: 14.61 to 24.09 million) and 17.67 thousand (95% UI: 14.63 to 21.19 thousand), respectively, with age-standardized incidence and death rates of 243.51 (95% UI: 186.01 to 307.48) and 0.22 (95% UI: 0.18 to 0.27) per 100,000 populations. Age-standardized incidence and death rates peaked in the 20-24 age group. From 1990 to 2021, the age-standardized incidence and death rates of MSMIs decreased, with EAPCs of -1.20 (95% [confidence interval] CI: -1.26 to -1.13) and -2.49 (95% CI: -2.95 to -2.03) respectively. The largest increase in the age-standardized incidence rate in 21 GBD regions was found in Australasia (EAPC: 0.70; 95%CI:0.52 to 0.89), and the largest increase in the age-standardized death rate was found in Oceania (EAPC:0.70; 95%CI: 0.51 to 0.88). The largest increase in the age-standardized incidence rate in 204 countries was found in Australia (EAPC:1.80; 95%CI:1.40 to 2.20), and the largest increase in the age-standardized death rate was found in Kazakhstan (EAPC:3.42; 95%CI: 2.56 to 4.29). Both the age-standardized incidence (R = -0.76, P < 0.001) and death rates (R = -0.65, P < 0.001) show a negative correlation with SDI levels.
This study reveals a decreasing trend in the global burden of MSMIs, yet disparities persist, particularly in 20-24 age group, lower SDI regions,and regions and countries with increasing burdens. These findings underscore the need for targeted interventions to address the remaining challenges in MSMIs, especially in more vulnerable populations.
孕产妇败血症和其他孕产妇感染（MSMIs）给全球健康带来了重大挑战，导致了相当高的发病率和死亡率。了解MSMIs的全球负担对于资源分配以及制定有针对性的预防和治疗策略至关重要。
分析1990年至2021年MSMIs的全球负担，并确定不同年龄组、地区、国家和社会人口学指数（SDIs）之间的差异。
数据来源于《2021年全球疾病负担研究》（GBD 2021），按年龄、SDI水平、地区和国家进行分层。使用2021年的年龄标准化发病率和死亡率及其1990年至2021年的估计年度百分比变化（EAPCs）来衡量当前负担和时间趋势。
2021年，MSMIs的发病数和死亡数估计分别为1905万（95%[不确定区间]UI：1461万至2409万）和1.767万（95%UI：1.463万至2.119万），年龄标准化发病率和死亡率分别为每10万人243.51（95%UI：186.01至307.48）和0.22（95%UI：0.18至0.27）。年龄标准化发病率和死亡率在20 - 24岁年龄组达到峰值。1990年至2021年，MSMIs的年龄标准化发病率和死亡率下降，EAPCs分别为 -1.20（95%[置信区间]CI：-1.26至 -1.13）和 -2.49（95%CI：-2.95至 -2.03）。在21个GBD地区中，年龄标准化发病率增幅最大的是澳大拉西亚（EAPC：0.70；95%CI：0.52至0.89），年龄标准化死亡率增幅最大的是大洋洲（EAPC：0.70；95%CI：0.51至0.88）。在204个国家中，年龄标准化发病率增幅最大的是澳大利亚（EAPC：1.80；95%CI：1.40至2.20），年龄标准化死亡率增幅最大的是哈萨克斯坦（EAPC：3.42；95%CI：2.56至4.29）。年龄标准化发病率（R = -0.76，P < 0.001）和死亡率（R = -0.65，P < 0.001）均与SDI水平呈负相关。
本研究揭示了MSMIs全球负担呈下降趋势，但差异依然存在，尤其是在20 - 24岁年龄组、低SDI地区以及负担增加的地区和国家。这些发现强调了需要采取有针对性的干预措施来应对MSMIs中仍然存在的挑战，特别是在更脆弱的人群中。
