Maternal Disorders among Women Aged 15 to 49 Years Global Trends, Inequalities, and Projections from the GBD Study 2021

Abstract Background Maternal disorders remain a pressing global health concern, especially in low-resource settings. Despite overall progress, persistent inequalities continue. This study examines the global burden of six maternal conditions—Maternal Hemorrhage, Maternal Sepsis and Other Maternal Infections, Maternal Hypertensive Disorders, Maternal Obstructed Labor and Uterine Rupture, Maternal Abortion and Miscarriage, and Ectopic Pregnancy—from 1990 to 2021, focusing on disease burden and disparities. Methods We used Global Burden of Disease Study 2021 data for women aged 15 to 49, analyzing disability-adjusted life years (DALYs) and incidence. The Sociodemographic Index (SDI) contextualized inequalities. Slope and concentration indices assessed disparities, while decomposition analyses explored drivers of DALY changes. Joinpoint regression and age-period-cohort analysis identified epidemiological shifts, and a Bayesian age-period-cohort model projected future incidence. Results Although absolute disparities in maternal disorders narrowed between 1990 and 2021, relative inequalities often increased. Low-SDI regions experienced slower declines or rises in burden, driven by demographic expansion offsetting epidemiological improvements. Decomposition analyses indicated that population growth remains a central barrier, while epidemiological gains substantially reduced DALYs. Projections suggest continued incidence declines, underscoring current intervention effectiveness but also persistent inequities. Conclusion Global maternal disorders have declined overall, yet inequalities have widened. Targeted interventions—such as improved maternal nutrition, education, reproductive health services, and enhanced screening—are crucial in low-SDI regions. Strengthening these measures can foster more equitable and sustainable maternal health outcomes, aligning with global efforts to reduce maternal morbidity and mortality.