Zhao Jiefeng, Miao Daxing, Xiao Tianbao, Yang Tao, Chen Jiang, Lai Xiangquan
Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China.
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shanxi Province, China.
PLoS One. 2025 Sep 10;20(9):e0331034. doi: 10.1371/journal.pone.0331034. eCollection 2025.
The incidence of inflammatory bowel disease (IBD) peaks between the ages of 15 and 40. This age range coincides with women of childbearing age (WCBA), who face unique challenges like adverse pregnancy outcomes and heightened anxiety. Despite the rising global prevalence of IBD, particularly among younger populations, the burden of IBD among women, especially WCBA, remains underexplored.
This study utilized data from the Global Burden of Disease (GBD) Study 2021 to examine the prevalence, disability-adjusted life-years (DALYs), and mortality of IBD among women and WCBA from 1990 to 2021. The estimated annual percentage change (EAPC) in age-standardized (AS) rates was calculated to quantify temporal trends. The relationship between the socio-demographic index (SDI) and AS prevalence, DALYs rate, and mortality was assessed using methodologies such as the slope index of inequality, concentration index, frontier analysis, decomposition analysis, and the Bayesian Age-Period-Cohort model.
From 1990 to 2021, a significant global decline was observed in the AS prevalence rate (ASPR), DALYs rate (ASDR), and mortality rate (ASMR) of IBD among women. For WCBA, the global prevalence rate decreased slightly, while the DALYs rate increased slightly, and mortality remained unchanged. Significant variations in trends were noted across different SDI and GBD regions. In 2021, the highest ASPR, ASDR, and ASMR for female IBD were reported in Australasia, high-income North America, and Western Europe, respectively. The most pronounced upward trends were observed in East Asia, Australasia, and high-income North America. China, Mauritius, and Kuwait experienced the most significant increases in prevalence, DALYs, and mortality rates among WCBA. Health inequalities across socioeconomic strata decreased, but substantial gaps remained, particularly in India.
This study reveals a global decline in the burden of IBD among women and WCBA from 1990 to 2021, with notable regional disparities. The decreasing trends highlight the effectiveness of certain interventions and improvements in healthcare. However, the increasing burden in some regions and for certain age groups, along with significant gaps identified in frontier analysis, emphasize the need for targeted public health strategies and resource allocation to further reduce the burden of IBD among women and WCBA.
炎症性肠病（IBD）的发病率在15至40岁之间达到峰值。这个年龄范围与育龄妇女（WCBA）重合，她们面临着诸如不良妊娠结局和焦虑加剧等独特挑战。尽管全球IBD患病率不断上升，尤其是在年轻人群中，但IBD在女性，特别是WCBA中的负担仍未得到充分研究。
本研究利用了2021年全球疾病负担（GBD）研究的数据，以考察1990年至2021年期间女性和WCBA中IBD的患病率、伤残调整生命年（DALYs）和死亡率。计算年龄标准化（AS）率的估计年度百分比变化（EAPC）以量化时间趋势。使用不平等斜率指数、集中指数、前沿分析、分解分析和贝叶斯年龄-时期-队列模型等方法评估社会人口指数（SDI）与AS患病率、DALYs率和死亡率之间的关系。
从1990年到2021年，全球女性IBD的AS患病率（ASPR）、DALYs率（ASDR）和死亡率（ASMR）均出现显著下降。对于WCBA，全球患病率略有下降，而DALYs率略有上升，死亡率保持不变。不同SDI和GBD区域的趋势存在显著差异。2021年，澳大利亚、高收入的北美和西欧分别报告了女性IBD最高的ASPR、ASDR和ASMR。东亚、澳大利亚和高收入北美出现了最明显的上升趋势。中国、毛里求斯和科威特的WCBA患病率、DALYs和死亡率增长最为显著。社会经济阶层之间的健康不平等有所减少，但仍存在巨大差距，尤其是在印度。
本研究揭示了1990年至2021年期间全球女性和WCBA中IBD负担的下降，存在显著的区域差异。下降趋势凸显了某些干预措施的有效性和医疗保健的改善。然而，一些地区和特定年龄组负担的增加，以及前沿分析中发现的巨大差距，强调需要有针对性的公共卫生战略和资源分配，以进一步减轻女性和WCBA中IBD的负担。
