Burden of maternal disorders in China from 1990 to 2019: Analysis of the Global Burden of Disease Study 2019

Abstract

Background Efforts to quantify the burden of maternal disorders at the national and provincial levels are valuable for resource allocation and for development and adoption of public health policies. Methods Following the methods of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, the prevalence of maternal disorders and the resulting disability-adjusted life years (DALYs), years lived with disability(YLD), deaths, and years of life lost (YLL) at the national and provincial levels in China were examined for the 1990–2019 period. Estimated annual percentage changes (EAPCs) were calculated to estimate the trends of age-standardized rate (ASR) of prevalence, DALYs, death, and YLD due to maternal disorders and its main subcategories from 1990 to 2019. Findings In 2019, China had an estimated 0.85 million cases of maternal disorders (95% uncertainty interval: 0.65–1.08 million), with a 73% decline in absolute numbers from 1990 to 2019. The ASR of prevalence, DALYs and death for overall maternal disorders showed decreasing trends in China from 1990 to 2019 with the EAPCs being −3.25(95% confidence interval [CI] = −3.86 to −2.64), −8.07 (95% CI= −9.14 to −6.98), and −7.04 (95% CI= −7.99 to −6.07), respectively. The most pronounced decreases in trends in ASR of prevalence, DALYs and death were observed for maternal hemorrhage. Shandong, Hong Kong, Macao showed no significant trends in ASR of prevalence. Notably, the trends in ASR of prevalence due to maternal hypertensive disorders had been stable in China and most provinces. The trends in ASR of DALYs and death decreased the most in Jiangxi province. Interpretation The disease burden of prevalence, DALYs and death for overall maternal disorders decreased significantly in China from 1990 to 2019, however, the trends in ASR of prevalence due to maternal hypertensive disorders had been stable in China and most provinces. Funding The study is supported by grants from the Innovative Talent Support Plan of the Medical and Health Technology Project in Zhejiang Province (2021422878), Ningbo Science and Technology Project (202002N3152), Ningbo Health Branding Subject Fund (PPXK2018–02), Sanming Project of Medicine in Shen-zhen (SZSM201803080).

Global Burden of Endometriosis in 204 Countries and Territories from 1990 to 2019

“…To the best of our knowledge, the current study is the first to comprehensively analyze the burden of endometriosis from 1990 to 2019 at global, regional, and national levels and further explore the relationship between endometriosis burden estimates and SES. Compared with earlier GBD studies, the GBD 2019 used more sophisticated up-to-date statistical approaches, in addition to a unified and standardized approach, to obtain globally comparable estimates of the temporal trends and geographic patterns in the ASIRs and DALY rates of 369 diseases [12,13]. This makes the GBD datasets an ideal source of empirical data on preferred case definitions and study methods for epidemiologists [12,13].…”

“…Compared with earlier GBD studies, the GBD 2019 used more sophisticated up-to-date statistical approaches, in addition to a unified and standardized approach, to obtain globally comparable estimates of the temporal trends and geographic patterns in the ASIRs and DALY rates of 369 diseases [12,13]. This makes the GBD datasets an ideal source of empirical data on preferred case definitions and study methods for epidemiologists [12,13]. Despite these strengths, several limitations of the present study should be taken into consideration.…”

“…Laparoscopy is an effective auxiliary diagnostic method at present, and biopsy is performed when necessary [1,2]. Second, the diagnosis of endometriosis may be influenced by the variation in clinical symptoms not adequately captured, differences in clinical definitions between regions and individual practitioners, or the alternate interpretation of the same symptoms in different healthcare systems [13,14]. Third, population-based prevalence and incidence data on endometriosis were sparse or not available for many countries and regions where the level of health care is low.…”

Spatial Patterns of Gallbladder and Biliary Tract Carcinoma in China From 1990 to 2019: An Analysis at the Provincial Level

“…We used data from the 2019 GBD. The detailed methodology of data collection in the GBD has been reported elsewhere [9][10][11][12][13][14]. Briefly, the 2019 GBD estimated the burden of gallbladder and biliary tract carcinoma in China using the incidence, prevalence, and mortality, years of life lost (YLLs), years lived with disability (YLDs), and DALYs.…”