Global, regional and national burden of maternal and neonatal disorders from 1990-2021, with projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Objective: Maternal and neonatal health remains a global health priority, with persistent disparities in outcomes across regions and socioeconomic groups. We aim to assess current conditions and future projections in maternal and neonatal health worldwide. Methods: This study used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021. It included estimates of incidence, mortality, and disability-adjusted life years (DALYs) for six maternal disorders and four neonatal disorders across 204 countries and territories from 1990 to 2021. Trends were analyzed using an Auto Regressive Integrated Moving Average model to project outcomes to 2050. Results: From 1990 to 2021, most maternal disorders showed a declining trend in incidence, except for maternal hypertensive disorders, which increased by 15.2% (95% uncertainty interval [UI]: 8.1%, 21.0%). Maternal abortion and miscarriage showed the largest decline, with a 17.9% reduction in incidence (95% UI: -23.0%, -11.5%). Hemolytic disease and jaundice showed substantial decreases of 62.1% (95% UI: -63.8%, -59.6%) in males and 59.8% (95% UI: -62.7%, -59.1%) in females. While DALYs associated with most maternal disorders declined, DALYs for ectopic pregnancy increased by 37.8% (95% UI: 13.6%, 67.8%). Projections indicate that by 2050, DALYs for most disorders will continue to decrease, except for ectopic pregnancy, which is expected to rise by 471.04 (95% UI: 125.33 to 1770.39 thousand). Age-specific trends showed a shift in maternal disorder burden toward older age groups. Countries also displayed notable variation in maternal and neonatal disorder DALYs. Conclusions: Maternal and neonatal disorders continue to require global attention. Although the overall disease burden has decreased, progress is limited by rising burdens of hypertensive disorders and ectopic pregnancy, together with persistent geographic inequities. Targeted interventions and strengthened global collaboration are needed to reduce these disparities and promote health equity.