Global trends of depressive disorders among women of reproductive age from 1990 to 2021: a systematic analysis of burden, sociodemographic disparities, and health workforce correlations.

Abstract

Background: Depressive disorders significantly impact women of reproductive age (15-49 years), who face unique biological and social pressures-such as hormonal changes and caregiving responsibilities-that elevate their mental health risks. Despite rising prevalence, regional disparities in burden remain poorly understood. Moreover, no studies to date have examined the relationship between depressive disorders in women of reproductive age and different categories of health workforce. This study examines global, regional, and national trends from 1990 to 2021, highlighting socio-demographic disparities and exploring correlations with health workforce distribution.

Methods: Using data from the Global Burden of Disease Study, we examined the prevalence, incidence, and disability-adjusted life years (DALYs) of depression in women of childbearing age (15-49 years) across 204 countries and territories from 1990 to 2021. Long-term trends were assessed through estimated annual percentage change (EAPC), while decomposition analyses identified drivers of disease burden changes. We also analyzed correlations between depressive disorder burden and various health workforce categories using data from the GBD 2019 Health Workforce Collaborators.

Results: From 1990 to 2021, the global prevalence of depression in women of reproductive age rose by 67.58%, incidence by 71.44%, and DALYs by 69.08%. Notably, this burden increased dramatically during the COVID-19 pandemic, with prevalence rising by 17.86%, incidence by 24.51%, and DALYs by 20.80% between 2019-2021 alone. Regions with low sociodemographic index (SDI) saw the largest increase in absolute cases (157.80% for prevalence), while high SDI regions experienced the fastest rise in age-standardized rates (32.45% for prevalence). Among all SDI levels, the 15-19 age group exhibited the greatest increase. Decomposition analyses indicated that population growth primarily drove the increased disease burden, though epidemiological changes played a larger role in high SDI regions. Our analysis revealed significant correlations between depressive disorder burden and health workforce distribution. Notably, countries with high depressive disorder burden, such as Georgia, might benefit from increasing the number of Audiologists and Counsellors while optimizing the role of Medical Assistants and Community Health Workers in detection and referral.

Conclusion: The global burden of depression among women of childbearing age is increasing significantly, with a marked acceleration during the COVID-19 pandemic period. Notable disparities exist across regions and age groups, with differential impacts in pre-pandemic versus pandemic timeframes. The correlations between health workforce categories and depressive disorder burden underscore the need for targeted interventions and resource allocation. These findings highlight the urgent need for strengthened prevention and intervention efforts, particularly those tailored to socioeconomic differences and focused on this vulnerable population, with special attention to pandemic-related mental health challenges.