Global analysis of incidence trends and projections of liver cirrhosis among women of childbearing age: An observational study based on the Global Burden of Disease data

The rising incidence of liver cirrhosis among women of childbearing age is associated with increased maternal morbidity and potential adverse maternal health outcomes. This study aimed to analyze temporal trends of cirrhosis incidence and project future epidemiological patterns to guide targeted prevention and control strategies. We extracted liver cirrhosis incidence data from the Global Burden of Disease Study 2021, covering 204 countries and territories from 1992 to 2021. The analytical population included females aged 15 to 49 years. Trends across age groups, periods, and birth cohorts were analyzed using the age-period-cohort model. The Bayesian age-period-cohort model was utilized to forecast epidemiological trends through 2030. Between 1992 and 2021, global cirrhosis trends varied by etiology: alcohol-related cases increased (14,566.88–19,340.29) despite declining age-standardized incidence rates (1.22–0.94 per 100,000), while nonalcoholic fatty liver disease-related cirrhosis showed a continuous upward trend in both case counts and age-standardized incidence rate between 1992 and 2021 (reaching 16,095,135.50 cases and 831.02 per 100,000 population in 2021), with projections indicating it may rise to approximately 19.63 million cases (95% uncertainty interval = 16.36 million–22.89 million) by 2030. Low socio-demographic index regions bore the highest burden. Projections through 2030 suggest a potential rising global burden, particularly for alcohol-related cases, with divergent trends projected for China (decreasing) and India (increasing). The global incidence of liver cirrhosis among women of childbearing age is rising, in population-level correlation with the growing burden of nonalcoholic fatty liver disease and regional gaps in viral and alcohol-related cirrhosis etiologies. These findings highlight the potential need for region-specific prevention strategies. Limitations include Global Burden of Disease data quality, ecological bias, and insufficient pregnancy-specific data for detailed incidence trend analysis.