The global, regional, and national burden of maternal hypertensive disorder in 204 countries and territories, 1990–2021: Results from the Global Burden of Disease Study 2021

Background: Maternal hypertensive disorder (MHD) is a significant global health concern, affecting 5% to 10% of pregnant women. We aimed to systematically estimate the global, regional, and national burden and temporal trends of MHD from 1990 to 2021. Methods: Data including the incidence, deaths, and disability-adjusted life years (DALYs), along with their age-standardized rates (ASRs) of MHD were obtained from the Global Burden of Disease Study 2021 and stratified by age and the sociodemographic index (SDI). An age-period cohort (APC) model was employed to clarify the impacts of age, period, and cohort. Decomposition and frontier analyses were used to assess the influencing factors and disease disparities, respectively. Results: In 2021, there were 18,050,085 (95% uncertainty interval [UI]: 15,356,124 to 21,519,204) incident cases, 38,147 (95% UI: 31,879 to 46,096) deaths and 2,469,637 (95% UI: 2,083,398 to 2,958,213) DALYs cases globally. The ASRs of incidence, deaths, and DALYs significantly decreased from 1990 to 2021. The burden of MHD was negatively correlated with the SDI level. Age-specific analysis revealed the highest burden existed in the 20-34 age group, with increasing trends in the 35-54 age group in high SDI regions. The APC model highlighted significant period and cohort effects, with improvements in high-middle SDI regions. Conclusions: Although the global burden of MHD has decreased, significant disparities persist, particularly in low SDI regions, requiring targeted interventions such as strengthening healthcare infrastructure and international cooperation to address the burden. In high SDI regions, managing lifestyle risk factors is also crucial in pregnant women with advanced age.