Global, regional, and national burden of maternal hemorrhage from 1990 to 2021, with projections to 2050: Insights from the Global Burden of Disease Study 2021

OBJECTIVE: Maternal hemorrhage (MH) remains a significant global health issue. Despite advancements in prevention and management, the burden of MH varies considerably across different regions. This study aimed to assess the current status and temporal trends of MH burden at global, regional, and national levels and to project its future trajectory through 2050. METHODS: Data were sourced from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The study estimated the age-standardized incidence rate (ASIR), the age-standardized death rate (ASDR), the disability-adjusted life years (DALY) rate, and the age-standardized maternal mortality ratio (MMR) with 95% uncertainty intervals (UIs) of MH globally and regionally. Changes in the burden of MH were assessed using the estimated annual percentage change (EAPC). The Bayesian age-period-cohort model was used to forecast disease burden of MH until 2050. RESULTS: In 2021, the global burden of MH remained substantial, with an estimated 13.96 million new cases and an ASIR of 176.9 per 100 000 (95% UI: 138.3-225.8). Significant regional disparities were observed. Low Socio-Demographic Index (SDI) regions had the highest ASIR (376 per 100 000; 95% UI: 293.5-484), while high SDI regions reported the lowest (93.1 per 100 000; 95% UI: 73.4-115.8). Western Sub-Saharan Africa exhibited the highest ASIR globally. Additionally, Western Sub-Saharan Africa recorded the highest ASDR (3.5734 per 100 000; 95% UI: 2.6902-4.74), the highest DALY rate (215.2 per 100 000; 95% UI: 163.5-284.7), and the highest MMR (90.4 per 100 000 live births; 95% UI: 68.2-120.6). In contrast, high SDI regions reported the lowest ASDR and DALY rate. From 1990 to 2021, a downward trend was observed in the global ASIR, ASDR, DALY, and MMR for MH, and projections indicated a continued decline in the global burden of MH. CONCLUSION: The global burden of MH has decreased over the past three decades. However, significant regional disparities persisted. Future initiatives should prioritize the enhancement of healthcare systems in specific regions to further mitigate MH-related morbidity and mortality. Projections suggested a continued global decline in the burden of MH.