Maternal sepsis and other maternal infections: Global Burden from 1990 to 2021.

BACKGROUND

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.

OBJECTIVES

To analyse the global burden of MSMIs from 1990 to 2021, and identify disparities across age groups, regions, countries, and socio-demographic indexes (SDIs).

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.