Zhao Junde, Gong Ruiting, Sui Xiaohui, Wang Zuocheng, Bian Xiaotao, Tseng Yiider
Shandong University of Traditional Chinese Medicine, Jinan, 250335, Shandong, China.
Obstetrics and Gynecology Department, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250001, China.
BMC Pregnancy Childbirth. 2025 Jul 2;25(1):680. doi: 10.1186/s12884-025-07777-9.
Maternal hypertensive disorders (MHD) are a leading cause of maternal and fetal mortality, with profound short- and long-term public health impacts. MHD epidemiology remains poorly controlled, and the incidence rate has shown an increase over the past few decades. Therefore, a comprehensive assessment of global burden and prevalence inequalities holds considerable significance for optimizing public health strategies.
The global burden and epidemic trend of MHD from 1990 to 2021 were investigated, and the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were examined utilizing the Global Burden of Disease (GBD). The trends were stratified by age and socio-demographic index (SDI), and further analysis was performed to delve into the correlation between SDI and incidence, prevalence, mortality, and DALYs. Additionally, a Bayesian Age-Period Cohort (BAPC) model was constructed to predict the burden of disease in MHD from 2022 to 2046.
The DALYs induced by MHD decreased significantly from 3.48 million (95% UI, 3.09-3.87 million) in 1990 to 2.47 million (95% UI, 2.08-2.96 million) in 2021, involving an Excess Annual Percentage Change (EAPC) of -2.10. Both the age-standardized DALYs rate (ASDR, AAPC = -2.11) and the age-standardized incidence rate (ASIR, AAPC = -0.60) exhibited evident decreasing trends. The ASDRs of all the age-stratified subgroups decreased as well. Notably, the largest declines were observed in the 20-24 age group with an EAPC of -2.39 (95% UI: -2.56, -2.23). The ASIR exhibited an obvious negative correlation with SDI, and the inequality tended to shrink. Projections for 2046 indicate that global ASDR and ASIR are expected to sustain their downward trajectory. Globally, ASDR in MHD linked to iron deficiency decreased significantly (EAPC = -2.03), with High-middle SDI countries experiencing particularly steep reductions (EAPC = -4.25).
This study performed a comprehensive analysis of the global burden of MHD and observed regional and national inequalities. The investigation also identified a correlation between MHD and SDI, and most regions exhibited an overall declining trend in disease burden. However, further investigations should still be conducted to assist the establishment of public health strategies for MHD prevention.
孕产妇高血压疾病（MHD）是孕产妇和胎儿死亡的主要原因，对短期和长期公共卫生都有深远影响。MHD的流行病学仍未得到有效控制，且发病率在过去几十年中呈上升趋势。因此，全面评估全球负担和患病率不平等对于优化公共卫生策略具有重要意义。
调查了1990年至2021年MHD的全球负担和流行趋势，并利用全球疾病负担（GBD）研究了发病率、患病率、死亡率和伤残调整生命年（DALY）。趋势按年龄和社会人口指数（SDI）进行分层，并进一步分析以深入探讨SDI与发病率、患病率、死亡率和DALY之间的相关性。此外，构建了贝叶斯年龄-时期-队列（BAPC）模型来预测2022年至2046年MHD的疾病负担。
MHD导致的DALY从1990年的348万（95%UI，309万-387万）显著下降至2021年的247万（95%UI，208万-296万），年度超额百分比变化（EAPC）为-2.10。年龄标准化DALY率（ASDR，AAPC = -2.11）和年龄标准化发病率（ASIR，AAPC = -0.60）均呈现明显下降趋势。所有年龄分层亚组的ASDR也都下降。值得注意的是,20-24岁年龄组下降幅度最大，EAPC为-2.39（95%UI：-2.56，-2.23）。ASIR与SDI呈明显负相关，且不平等程度趋于缩小。2046年的预测表明，全球ASDR和ASIR预计将保持下降趋势。在全球范围内，与缺铁相关的MHD的ASDR显著下降（EAPC = -2.03），高中等SDI国家下降尤为明显（EAPC = -4.25）。
本研究对MHD的全球负担进行了全面分析，并观察到区域和国家间的不平等。该调查还确定了MHD与SDI之间的相关性，且大多数地区的疾病负担总体呈下降趋势。然而，仍应进行进一步调查，以协助制定预防MHD的公共卫生策略。
