Table 1_Trends in the disease burden of maternal sepsis and other maternal infections attributable to iron deficiency from 1990 to 2021 and its projection until 2050.docx

BackgroundIron deficiency is a key risk factor for maternal sepsis and other maternal infections (MSMIs). This study aims to investigate the trends of MSMIs attributable to iron deficiency based on data from the Global Burden of Disease (GBD) 2021 database.
MethodsData on MSMIs attributable to iron deficiency were utilized. Epidemiological tendencies were assessed using the estimated annual percentage change (EAPC) for age-standardized rate in mortality (ASMR) and disability-adjusted life years (DALYs). The correlation between socio-demographic index (SDI) and age-standardized rates (ASRs) of deaths and DALYs in different GBD regions was evaluated using the Pearson correlation coefficient. Bayesian age-period-cohort models were applied to predict the burden of MSMIs attributable to iron deficiency by 2050.
ResultsFrom 1990 to 2021, the global mortality and DALYs of MSMIs attributable to iron deficiency declined, with an EAPC of −2.49 (95% confidence interval (CI): −2.91 to −2.06) and −2.51 (95% CI: −2.92 to −2.10), respectively. The decrease of ASMR was the most in the high-middle SDI regions, while for age-standardized DALY rate, the most decrease was in the low-middle SDI regions. In 2021, Somalia represented the greatest burdens on deaths and DALYs, with an ASMR of 2.98 per 100,000 persons (95% uncertainty interval (UI): 1.30–5.12) and an age-standardized DALY rate of 177.38 per 100,000 persons (95% UI: 76.95–299.71). East Asia had the most decreases in the burdens of deaths and DALYs. Moreover, Equatorial Guinea represented the largest decreases in ASMR and age-standardized DALY rate. In 1990 and 2021, the peaks of MSMIs-related deaths (1,124 cases and 724 cases) and DALYs (82,593 cases and 53,355 cases) were found in the 20–24 years age group. The ASMR and age-standardized DALY rate of MSMIs attributable to iron deficiency were negatively correlated with SDI. Projections indicated a continued decrease in the burden of MSMIs attributable to iron deficiency by 2050.
ConclusionsOver the past 30 years, the global burden of MSMIs attributable to iron deficiency has been decreasing, which is predicted to continually decrease by 2050. Targeted strategies for improving management in MSMIs attributable to iron deficiency should focus on 20–24 years population.