Comparison of the burden of maternal hypertensive disorders between China and the globe from 1990 to 2023: epidemiological trends and age-period-cohort analysis

To compare epidemiological trends and burden of maternal hypertensive disorders (MHD) between China and the globe from 1990 to 2023 and project future trends through 2035.
Based on Global Burden of Disease (GBD) 2023 data, temporal trends and age-period-cohort effects were analyzed using Joinpoint regression, Age-Period-Cohort (APC) models, and Nordpred forecasting.
From 1990 to 2023, China’s MHD incident cases and disability-adjusted life years (DALYs) decreased by 79.73% and 95.33%, respectively. China’s age-standardized incidence rate (ASIR) and age-standardized DALY rate (ASDR) remained consistently lower than global averages with a greater magnitude of decline. Joinpoint analysis showed China’s ASIR fluctuated, while ASDR declined steadily. APC models revealed an incidence increase among Chinese females aged 35−54, particularly in the 45−49 group (local drift: 3.28%/year), while global incidence declined across all ages. In China, incidence risk was lowest in 2009–2013, with birth cohort risk peaking in 1972−1976. Overall MHD burden is projected to continue declining by 2035.
Despite overall progress, the rising risk among older pregnant women in China remains a key challenge, necessitating enhanced age-based screening and specialized perinatal care.

The overall burden of MHD in China exhibited a declining trend, with a magnitude of reduction exceeding the global average.
Advanced maternal age poses a significant challenge in China, where the incidence of MHD among older women has increased, contrasting the declining global trend for this group.
The relative risk of MHD incidence in China initially decreased and then increased across time periods, while it showed an initial increase followed by a decrease across successive birth cohorts.

The overall burden of MHD in China exhibited a declining trend, with a magnitude of reduction exceeding the global average.
Advanced maternal age poses a significant challenge in China, where the incidence of MHD among older women has increased, contrasting the declining global trend for this group.
The relative risk of MHD incidence in China initially decreased and then increased across time periods, while it showed an initial increase followed by a decrease across successive birth cohorts.