Global burden and trends of depression among women of childbearing age, 1990–2021

Abstract

Objectives

To evaluate the global, regional, and national burden and temporal trends of depression among women of childbearing age (WCBA) from 1990 to 2021, and to identify major risk factors contributing to its disease burden.

Study design

Population-based trend analysis.

Methods

Data on prevalence, incidence, and disability-adjusted life years (DALYs) of depression in WCBA were retrieved from the Global Burden of Disease (GBD) 2021 database, covering 204 countries and territories. Age-standardized prevalence rate (ASPR) and age-standardized death rate (ASDR) were analyzed using estimated annual percentage change (EAPC). Inequality, decomposition, and frontier analyses were conducted to explore geographic disparities, drivers of burden changes, and potential for improvement.

Results

Between 1990 and 2021, the global ASPR of depression among WCBA increased from 5545.28 to 6173.45 per 100,000 population (1.33 % increase), with the largest rise observed in high-SDI regions. High-income North America recorded the highest ASPR in 2021 (10,443.59 per 100,000), whereas East Asia had the lowest (3700.00 per 100,000). The ASDR demonstrated heterogeneous patterns, with overall declines but recent increases since 2019. Major risk factors in 2021 included behavioral risks, child sexual abuse, bullying victimization, and intimate partner violence, with substantial regional variation. Decomposition analysis indicated that population growth was the dominant driver of increased DALYs.

Conclusions

The global burden of depression among WCBA has risen over the past three decades, with pronounced disparities across regions and SDI levels. High-income countries continue to face growing challenges, while inequalities persist despite narrowing trends. These findings underscore the urgent need for region-specific, gender-sensitive strategies to improve prevention and mental health care for WCBA worldwide.