Yuan Aijuan, Huang Hui
Department of Obstetrics and Gynecology, Ningbo University Affiliated People's Hospital, Zhejiang, China.
Front Med (Lausanne). 2025 Aug 1;12:1498694. doi: 10.3389/fmed.2025.1498694. eCollection 2025.
We aimed to provide a comprehensive overview of the epidemiology of hypertensive disorders of pregnancy (HDP) from 1990 to 2021, examining incidence and trends across national, continental, and global levels.
HDP were assessed by calculating the age-standardized incidence rate (ASIR), age-standardized disability-adjusted life years (DALYs) rate, and the estimated annual percentage change (EAPC) for each region and country. The Global Burden of Disease (GBD) 2021 Study age-standardized rates, which were obtained from 204 countries and territories, were used to analyze the burden based on age and sociodemographic index (SDI).
The global burden of HDP has changed substantially between 1990 and 2021. The total number of DALYs was 2.47 million (95% UI: 2.08 to 2.96), and the ASIR was 461.94 per 100,000 in 2021. The estimated annual percentage change (EAPC) for the DALY rate was -2.10 (95% CI: -2.15 to -2.04), and the EAPC for ASIR was -0.51 (95% CI: -0.56 to -0.45). The Russian Federation, Romania, and Georgia had the greatest increases in ASIR over time. Guam, American Samoa, and the United Republic of Tanzania had the highest EAPC for the DALY rate. Analysis by age showed that maternal hypertensive disorders caused the highest DALYs among women aged 25-39 years and the lowest DALYs among those aged 50-54 years. There was a positive relationship between ASIR and SDI. The same trend was observed for the DALY rate.
Our findings revealed that DALY rates and incidence rates of HDP decreased in most regions, except in areas with lower sociodemographic indices, such as the Caribbean. The greatest burden of HDP was observed among women aged 25-39 years. These results underscore the need for targeted interventions in low-SDI regions and highlight the importance of addressing HDP as a key component of maternal health initiatives globally.
我们旨在全面概述1990年至2021年妊娠高血压疾病（HDP）的流行病学情况，研究国家、大陆和全球层面的发病率及趋势。
通过计算每个地区和国家的年龄标准化发病率（ASIR）、年龄标准化残疾调整生命年（DALY）率以及估计年变化百分比（EAPC）来评估HDP。基于204个国家和地区的《2021年全球疾病负担（GBD）研究》年龄标准化率，用于分析基于年龄和社会人口学指数（SDI）的负担情况。
1990年至2021年间，HDP的全球负担发生了显著变化。2021年DALY总数为247万（95% UI：208万至296万），ASIR为每10万人461.94例。DALY率的估计年变化百分比（EAPC）为-2.10（95% CI：-2.15至-2.04），ASIR的EAPC为-0.51（95% CI：-0.56至-0.45）。随着时间推移，俄罗斯联邦、罗马尼亚和格鲁吉亚的ASIR增幅最大。关岛、美属萨摩亚和坦桑尼亚联合共和国的DALY率EAPC最高。按年龄分析表明，孕产妇高血压疾病在25至39岁女性中导致的DALY最高，在50至54岁女性中导致的DALY最低。ASIR与SDI之间存在正相关关系。DALY率也观察到相同趋势。
我们的研究结果显示，除了社会人口学指数较低的地区（如加勒比地区）外，大多数地区的HDP的DALY率和发病率均有所下降。25至39岁女性中观察到的HDP负担最重。这些结果强调了在低SDI地区进行有针对性干预的必要性，并突出了将HDP作为全球孕产妇健康倡议的关键组成部分加以应对的重要性。
