Ectopic Pregnancy Mortality Trends in BRICS: Age-Period-Cohort Analysis of Global Burden Disease 2021 Data and 2030 Forecast

Purpose: Ectopic pregnancy (EP) is a significant contributor to maternal mortality, posing a major burden on women in developing countries. This study examined global trends in EP mortality from 1982 to 2021, focusing on developing nations represented by BRICS countries (Brazil, Russian Federation, India, China, and South Africa). Methods: Based on the Global Burden Disease (GBD) 2021, an analysis of EP mortality was conducted by location (global and BRICS), age group (15-49 years), and years (1982-2021). The age-period-cohort (APC) model was utilized to estimate net drift, local drift, age effects, period effects, and cohort effects from 1982 to 2021. Furthermore, the Autoregressive Integrated Moving Average (ARIMA) model was employed to forecast EP mortality from 2022 to 2030. Results: Globally, the number of deaths due to EP reached 6442 (95% CI: 5368 to 7796) in 2021, representing a 55.08% increase compared with 1982. Despite rising absolute deaths, the global Age-Standardized Mortality Rate (ASMR) declined by 15.79%, reaching 0.16 per 100,000 population in 2021 (95% UI: 0.14 to 0.20), indicating a reduction in population-level risk after accounting for demographic structure. EP mortality predominantly affected individuals aged 20-39 years across regions. APC analyses revealed distinct period and cohort effects, with marked heterogeneity across BRICS countries. Net Drift estimates ranged from a substantial annual decline in the Russian Federation (-10.12%) to a modest decrease in India (-1.62%), with Brazil, China, and South Africa showing intermediate downward trends. Conclusion: From 1982 to 2021, varying advancements in managing EP were observed among BRICS nations. Tailored financial allocations and policy measures aided in lowering EP mortality. Enhancing cross-country collaboration and knowledge exchange within BRICS countries is crucial for further ameliorating EP outcomes.