What is the clinical evidence from this study?

Study design: Observational. Population: Maternal hypertensive disorder. Intervention: Observation over time (1992-2021) vs. 1992 baseline. Primary outcome: Global age-standardized incidence rate of maternal hypertensive disorder (per 100,000 population) (Net drift -0.71%, 95% CI -0.98 to -0.43).

What does this research mean for the field?

From 1992 to 2021, the global age-standardized incidence rate of maternal hypertensive disorders decreased by 13.40%, despite varying trends across BRICS nations such as increasing incidence in China and the Russian Federation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 8, 2024BMC Pregnancy and Childbirth14 citationsOpen Access

Time trends in maternal hypertensive disorder incidence in Brazil, Russian Federation, India, China, and South Africa (BRICS): an age-period-cohort analysis for the GBD 2021

XWXiaochan WangNanjing Agricultural University FCFangqun ChengHunan University QFQ FuXiangyang Central Hospital

Key Result

From 1992 to 2021, the global age-standardized incidence rate of maternal hypertensive disorders decreased by 13.40%, with an estimated annual net drift of -0.71%.

Study Design

Type

Observational

Structured PICO

Population

Females globally and in BRICS countries (Brazil, Russian Federation, India, China, South Africa) from 1992 to 2021, analyzed for maternal hypertensive disorder incidence.

Outcome

Incidence trends of maternal hypertensive disorder (MHD) including number of cases, all-age incidence rate, and age-standardized incidence rate

Between 1992 and 2021, the global age-standardized incidence of maternal hypertensive disorders decreased, though absolute case numbers increased and trends varied significantly among BRICS nations.

Main Result

Effect estimate: Net drift -0.71% (95% CI -0.98 to -0.43)

Absolute Event Rate: 461.94% vs 533.44%

Limitations

Availability and quality of raw data are limiting factors in estimating the incidence of MHD
Lack of granular analysis to capture subnational variations
Period and cohort effects were investigated using cross-sectional data from the most recent GBD 2021 estimates

Abstract

OBJECTIVES: Maternal hypertensive disorder (MHD) is a leading cause of significant maternal and fetal mortality and morbidity. The BRICS nations are crucial in the global MHD landscape, given their large populations and varied healthcare infrastructures. This investigation evaluates the incidence trends of MHD in BRICS countries from 1992 to 2021. STUDY DESIGN AND METHODS: Data on the number, all-age rate, age-standardized rate (ASR), and the relative change of MHD incidence from this study were sourced from the Global Burden of Disease (GBD) 2021 public dataset to investigate temporal trends in MHD incidence over three decades globally and in BRICS countries. The age-period-cohort (APC) model was used to estimate net drift, local drift, age-specific curves, and period (cohort) relative risks. RESULTS: A 15.87% increase in global MHD cases, alongside a 13.40% decrease in age-standardized incidence rates from 1992 to 2021. MHD incidence rates are declining across various BRICS age groups, except in China and Russian Federation, where most groups exhibit increasing trends. Annual net drift in MHD incidence ranges from - 4.25% in India to 2.38% in China. A shift in the age distribution of MHD cases from younger to older within the childbearing age range is observed in all BRICS nations. Countries exhibit similar age-effect patterns, with decreasing risk with increasing age, and varying period and cohort effects, indicative of differential control measures and temporal incidence trends. CONCLUSIONS: Global and BRICS-specific reductions in MHD incidence vary in magnitude. Customized preventive strategies, leveraging existing resources, are advisable for BRICS nations to address pregnancy complications. Enhancing primary healthcare and maternal care quality, particularly for older mothers, is imperative.

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