Trends and patterns of disease burden of maternal and neonatal sepsis and other infections attributable to malnutrition: a cohort analysis of GBD 1990–2021

Objective This study analyzed the global disease burden of maternal and neonatal sepsis and other infections (MNSOIs) attributable to malnutrition between 1990 and 2021, exploring influencing factors and predicting future trends.Methods Using the GBD 2021 database, we assessed the incidence and DALYs of MNSOIs across global subgroups (by sex, age, country, region, and SDI). We calculated age-standardized rates (ASRs) and annual percentage changes (estimated annual percentage changes [EAPCs]) and quantified health inequalities using the slope index of inequality (SII) and concentration index (CII). Decomposition analysis identified factors driving changes, and the autoregressive integrated moving average (ARIMA) model forecasted future trends.Results From 1990 to 2021, global ASRs for MNSOIs attributable to malnutrition declined (maternal EAPCs: –1.20, –2.47; neonatal EAPCs: –0.62, –0.75). However, ASRs remain higher in low SDI regions like Afghanistan, Somalia, and Chad, with increasing concentration. Maternal burden is higher in women aged 20–29, and neonatal burden is greater in early neonatal males. Australasia and Eastern Europe saw rising maternal burdens, while neonatal burdens increased in the Caribbean and Sub-Saharan Africa. Taiwan and the UK saw rapid increases in both burdens.Conclusion Despite progress, MNSOI-related disease burden remains high, especially in low SDI regions. Slow declines in neonatal burden emphasize the need for targeted nutritional interventions.