Global Burden and Temporal Trends of Idiopathic Epilepsy in Women of Childbearing Age: An Analysis of the Global Burden of Disease Study 1990-2021 and Forecast to 2036.

Abstract

Introduction: Idiopathic epilepsy is a common chronic neurological disorder. Women of childbearing age (WCBA) face unique physiological and social challenges in epilepsy management. However, there is a lack of comprehensive global studies evaluating the burden of idiopathic epilepsy in this population.

Methods: Using data from the Global Burden of Disease Study 2021, we assessed the prevalence, incidence, and disability-adjusted life years (DALYs) of idiopathic epilepsy among WCBA from 1990 to 2021 across global, regional, and national levels. Temporal trends were analyzed using estimated annual percentage change (EAPC), Joinpoint regression, and age-period-cohort (APC) models. Frontier and decomposition analyses were conducted to examine disparities and driving factors, and associations with sociodemographic index (SDI) were explored. A Bayesian APC model was used to project future burden through 2036.

Results: From 1990 to 2021, the global number of WCBA with idiopathic epilepsy increased from 3.54 million to 5.38 million, incidence cases rose from 0.44 million to 0.69 million, and DALYs rose from 2.40 million to 3.02 million. Age-standardized prevalence rate (ASPR) remained stable (EAPC = -0.06) with a recent uptick; age-standardized incidence rate (ASIR) slightly increased (EAPC = 0.16); and age-standardized DALYs (ASR-DALYs) declined (EAPC = -0.59). High-SDI regions showed relatively stable burden, while low and middle SDI regions experienced marked increases. Frontier analysis revealed a substantial gap between actual and achievable burden levels in many countries. Population growth was the primary driver of increased burden, while epidemiological improvements contributed more in high-SDI countries. Projections estimate that by 2036, the number of WCBA with epilepsy will reach approximately 7.13 million, with upward trends in ASPR, ASIR, and ASR-DALYs. The APC model indicated highest epilepsy risk during adolescence and divergent burden trends across SDI regions.

Conclusion: Despite improvements in ASR-DALYs, the global burden of idiopathic epilepsy in WCBA continues to rise, with stark regional disparities. Focused interventions in low and low-middle SDI regions and high-risk groups are urgently needed to optimize prevention and control strategies.