Maternal hypertensive disorders (MHD) pose significant health challenges globally, impacting millions of pregnancies. According to new research analyzing data from the Global Burden of Disease (GBD) study, the incidence and mortality rates associated with MHD have shown notable trends from 1990 to 2021. While there has been some progress, the findings also reveal persistent disparities across different regions and age groups.
Specifically, the age-standardized incidence rate (ASIR) of MHD has decreased from 554.35 per 100,000 in 1990 to 461.94 per 100,000 by 2021, representing an average annual percent change (AAPC) of -0.6%. The age-standardized death rate (ASDR) also saw significant reductions, declining from 1.94 per 100,000 to 0.97 per 100,000, with the ASDR reflecting a sharper AAPC of -2.18%. This development highlights the effectiveness of global public health initiatives aimed at improving maternal health outcomes.
Areas with lower socio-demographic index (SDI) faced the highest burden of MHD. For example, low SDI regions reported the highest ASIR of 1202.32 per 100,000 and ASDR of 3.38 per 100,000, indicating substantial challenges in managing hypertension during pregnancy. This stark difference emphasizes the inequalities faced by women in low-resource settings, where healthcare access and quality are often inadequate.
Younger age groups have shown the most significant improvements, particularly those aged 15-19, with declines of 1.62% per year for incidence and 2.57% yearly for mortality. More recent birth cohorts also exhibited greater improvements, demonstrating effectiveness of targeted health interventions over time. The findings affirm the importance of strategic healthcare approaches such as enhanced antenatal care and education aimed at younger populations.
Despite these positive trends, the study reveals alarming disparities between regions. For example, data from 2021 showed Western Sub-Saharan Africa had the highest ASIR with 1678.15 per 100,000, reflecting slow progress compared to East Asia, which maintained the lowest ASIR at 108.74 per 100,000. These disparities highlight the urgent need for targeted interventions to reduce MHD incidence, particularly in regions where the burden remains unacceptably high.
The age-period-cohort analyses utilized clear methodologies, which revealed significant patterns affecting MHD incidence and mortality. The study found the most substantial decline occurred among younger women, whereas slightly increasing rates were observed among older age groups (ages 30-34 and 35-39). This suggests the need for enhanced prenatal care strategies targeting older mothers, especially as trends indicate delayed childbearing is becoming more common.
Specifically, women aged 30 and above are now at higher risk of experiencing MHD, necessitating focus on prenatal screening and appropriate interventions during pregnancy. The increasing incidence of MHD among these older mothers warrants attention as it can negatively impact maternal and fetal health.
Results from countries like Libya, which showed the largest decline in ASIR with -3.67% annually, reinforce the importance of effective healthcare policies. Conversely, Ecuador noted the largest increase of 1.35%. For mortality rates, Jordan demonstrated the largest decline at -10.86% per year, showcasing effective public health strategies, whereas Guam experienced the largest increase of 0.88% per year.
Researchers are calling on nations, especially those with low SDI, to improve healthcare infrastructure, accessibility, and quality of maternal health services to close the persistent gap. Disparities are most pronounced among women from lower-income backgrounds who face obstacles such as lack of education and financial strain, contributing to higher rates of severe maternal complications.
Improving the healthcare systems, educating women about their maternal health, and ensuring accessible medical resources are central to mitigating the high incidence rates of MHD. Programs targeting the integration of education on pregnancy health care within communities can truly make significant differences.
Though advancements have been particularly pronounced over the past three decades, notable disparities call for urgent adjustments and renewed efforts to combat the challenges presented by maternal hypertensive disorders. The study clearly emphasizes the necessity of targeted, region-specific approaches alongside generalized improvements aimed at ensuring maternal health equity across the globe.
By enhancing awareness, adjusting healthcare strategies, and allocating resources effectively, it is possible to not only reduce the MHD burden but also pave the way for healthier pregnancies, securing the well-being of mothers and their children. These findings will support policymakers and healthcare officials as they design and implement impactful initiatives to combat maternal health issues head-on.