Global, Regional, and National Burden and Trends of Pelvic Organ Prolapse Among Women of Childbearing Age and Projected Trends to 2041 Using ARIMA Models: A Systematic Study Based on the GBD from 1990 to 2021

Purpose: Pelvic organ prolapse (POP) is a disorder significantly compromising the physical, mental, and social health of females. The economic POP burden within women of childbearing age (WCBA) is increasing substantially. It is important to understand the worldwide implications of POP to anticipate future trends and formulate appropriate prevention and management strategies for this population. Patients and Methods: Leveraging 2021 Global Burden of Disease (GBD) data, this study examines the 1990-2021 global, regional, and national POP burden within WCBA. Incidence and disability-adjusted life years (DALYs) were primary measures, alongside the sociodemographic index (SDI). Health disparities were examined based on the slope index of inequality (SII) and the Concentration Index. The main determinants of variation in disease burden (DB) were found via decomposition analysis. Future trends were forecast utilizing an autoregressive (AR) integrated moving average (ARIMA) model. Data were processed and visualized using R (v4.4.1; ggplot2), with final editing in Adobe Illustrator (CS5). Results: Globally, the POP burden among WCBA declined in 2021 in comparison to 1990. Age-specific analyses demonstrated that incidence and DALY rates rose as age increases, peaking in the 45-49 cohort. Inequality analysis revealed a narrowing gap between regions with high and low SDI. Nevertheless, lower-SDI countries and regions continued to experience a disproportionately greater burden. Decomposition analysis identified aging as the primary factor in high and high-middle SDI regions, and population rise as the predominant factor in low and low-middle SDI regions. Our ARIMA model projects a continuing downward trend in the prevalence of POP among WCBA. Conclusion: Although the POP burden among WCBA worldwide has decreased over the past 32 years, substantial health inequities persist, particularly in less developed countries and regions. Therefore, interventions targeting POP in WCBA are imperative to support progress toward the health-related Sustainable Development Goals articulated by the World Health Organization (WHO).