Global, regional, and national burden of pregnancy loss from 1990 to 2021: a systematic analysis of incidence and DALYs with projections to 2040

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction Pub Date : 2026-01-01 Epub Date: 2025-11-05 DOI:10.1016/j.jogoh.2025.103065

Shuangfei Xu, Jing Wang, Jinli Ding

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引用次数: 0

Abstract

Background

Pregnancy loss is one of the most prevalent pregnancy-related complications in women of reproductive age. The study aimed to investigate the global, regional, and national burden of pregnancy loss in 204 countries and regions worldwide from 1990 to 2021, based on Global Burden of Disease (GBD) 2021.

Methods

Data on the incidence, disability-adjusted life-years (DALYs), age-standardized incidence (ASIR), and age-standardized DALYs rate (ASDR) were extracted and analyzed from GBD 2021, by using joinpoint regression analysis, decomposition analysis, and the health inequality concentration analysis. The Bayesian age-period-cohort (BAPC) model was used to predict the trends up to 2040. The age-period-cohort model was applied to estimate the longitudinal age curves cohort and period relative risks.

Results

There were 38.64 million of pregnancy loss at the global level in 2021, with a decrease of 17.9 % compared to 1990. The DALYs, ASIR and ASDR all showed decreasing trend, mainly driven by epidemiological change (245.19 % and 143.13 % for incidence and DALYs, respectively). The lowest ASIR and ASDR were observed in high SDI regions, while low SDI regions had the highest. Andean Latin America had the highest ASIR (2129.91 per 100,000, 95 % UI: 1702.62, 2655.06), and Central Sub-Saharan Africa had the highest ASDR (179.29 per 100, 000, 95 % UI:125.24, 257.97). BAPC projections indicated continued global decline in both cases and incidence rate though 2040.

Conclusion

Although the global burden of pregnancy loss shows an overall decline from 1990 to 2021, it remains significant, especially in low and low-middle SDI regions, which indicates that the targeted decision-making efforts are needed to raise public awareness of this condition, improve management practices and strategies, and increase support to reduce the risk.

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1990年至2021年全球、区域和国家妊娠损失负担：发生率和伤残调整生命年的系统分析，并预测到2040年。

背景：妊娠丢失是育龄妇女最常见的妊娠相关并发症之一。该研究旨在基于全球疾病负担（GBD） 2021，调查1990年至2021年全球204个国家和地区的全球、区域和国家妊娠损失负担。方法：采用关节点回归分析、分解分析和健康不平等集中度分析，提取GBD 2021的发病率、残疾调整生命年（DALYs）、年龄标准化发病率（ASIR）和年龄标准化DALYs率（ASDR）数据并进行分析。使用贝叶斯年龄-时期-队列（BAPC）模型预测到2040年的趋势。采用年龄-时期-队列模型估计纵向年龄曲线队列和时期相对风险。结果：2021年全球发生3863万例妊娠丢失，比1990年下降17.9%。DALYs、ASIR和ASDR均呈下降趋势，主要受流行病学变化驱动（发病率和DALYs分别为245.19%和143.13%）。ASIR和ASDR在高SDI地区最低，而低SDI地区最高。撒哈拉以南非洲东部的ASIR最高（2103.18 / 10万，95% UI: 1600.8, 2704.18），撒哈拉以南非洲中部的ASDR最高（179.29 / 10万，95% UI:125.24, 257.97）。BAPC的预测表明，到2040年，全球病例和发病率都将继续下降。结论：尽管1990年至2021年全球妊娠损失负担总体下降，但仍明显下降，特别是在低、中低SDI地区，这表明需要有针对性的决策努力，提高公众对这一状况的认识，改进管理实践和策略，增加支持以降低风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of gynecology obstetrics and human reproduction Medicine-Obstetrics and Gynecology

CiteScore

3.70

自引率

5.30%

发文量

210

审稿时长

31 days

期刊介绍： Formerly known as Journal de Gynécologie Obstétrique et Biologie de la Reproduction, Journal of Gynecology Obstetrics and Human Reproduction is the official Academic publication of the French College of Obstetricians and Gynecologists (Collège National des Gynécologues et Obstétriciens Français / CNGOF). J Gynecol Obstet Hum Reprod publishes monthly, in English, research papers and techniques in the fields of Gynecology, Obstetrics, Neonatology and Human Reproduction: (guest) editorials, original articles, reviews, updates, technical notes, case reports, letters to the editor and guidelines. Original works include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses.