Trends in the Disease Burden of Migraine Among Women of Reproductive Age (15–49 Years) in Low- and Middle-Income Countries, 1990–2023

Purpose: Migraine disproportionately affects women of reproductive age (15– 49 years) in low- and middle-income countries (LMICs). This study comprehensively evaluates the trends in migraine burden in this vulnerable population between 1990 and 2023. Patients and Methods: Using data from the Global Burden of Disease studies 1990– 2023, we estimated the burden of migraine, including the number of incidence, prevalence, and disability-adjusted life years (DALYs), among reproductive-age women in LMICs. The analytical approaches included trend analysis (estimated annual percentage change), decomposition analysis, correlation analysis with Socio-demographic Index and Gross National Income, and forecasting using autoregressive integrated moving average models. Results: Between 1990 and 2023, migraine burden increased significantly among women aged 15– 49 in LMICs. Prevalent cases, incident cases, and DALYs rose by approximately 67%, 61%, and 68%, respectively. This increase was most marked in upper-middle-income countries. Decomposition analysis identified population growth as the predominant driver, accounting for 52% to 108% of the increase across metrics, whereas epidemiological changes exacerbated the burden in upper-middle-income settings. ARIMA modeling projected a continued rise in DALYs through 2050. Conclusion: Our model-based analysis estimates a substantial increase in the burden of migraine among reproductive-age women in LMICs. The variation in key drivers across income levels underscores the need for stratified public health strategies to mitigate this growing neurological disorder.