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Burden of Maternal Disorders in China from 1990 to 2017: Findings from the Global Burden of Disease Study 2017
146 Pages Posted: 20 Oct 2020
More...Abstract
Background: Efforts to quantify the burden of maternal disorders at the national and provincial levels are valuable for resource allocation and for development and adoption of public health policies.
Methods: Following the methods of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, the prevalence of maternal disorders and the resulting disability-adjusted life years (DALYs), years lived with disability, deaths, and years of life lost at the national and provincial levels in China were examined for the 1990–2017 period. Estimates were obtained for 10 main subcategories of maternal disorders: maternal hemorrhage, maternal sepsis and other maternal infections, maternal hypertensive disorders, maternal obstructed labor and uterine rupture, maternal abortion and miscarriage, ectopic pregnancy, indirect maternal death, maternal death aggravated by HIV/AIDS, late maternal death, and other maternal disorders. This study was in line with the Guidelines for Accurate and Transparent Health Estimates Reporting statement.
Findings: In 2017, China had an estimated 0.69 million cases of maternal disorders (95% uncertainty interval: 0.58–0.82 million). The age-standardized prevalence rate per 100,000 population decreased by 60.38% from 1990 to 2007 but increased by 13.4% from 2007 to 2017. The subcategory with the greatest increase was maternal hemorrhage (14.97%) from 2007 to 2017. A substantial reduction was observed in the burden of maternal disorders (including the main subcategories) based on the rates of age-standardized DALYs, deaths, and years of life lost at both national and provincial levels during both periods (1990–2007 and 2007–2017). Geographically, during 2007–2017, the greatest increases in the age-standardized prevalence rate of overall maternal disorders were concentrated in the central provinces. In contrast, the greatest decreases in the age-standardized DALY rate were found in the southwest and northwest provinces, and the central provinces showed smaller declines in this rate.
Interpretation: Despite substantial reductions in the burden of overall maternal disorders and the main subcategories, China has experienced an increase in the age-standardized prevalence of these disorders, and the most prevalent disorder has been maternal hemorrhage.
Funding Statement: The study is supported by grants from National Key R&D Program of China (2017YFC1310902, 2018YFC1315305), Ningbo Health Branding Subject Fund PPXK2018-02), Sanming Project of Medicine in Shen-zhen (SZSM201803080).
Declaration of Interests: No declare.
Ethics Approval Statement: The National Center for Chronic and Noncommunicable Disease Control and Prevention, reviewed and approved this study. Informed consent was waived because no identifiable information was included in the analyses. The GBD 2017 was in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting statement.
Keywords: maternal disorders ，disability adjusted life years，years lived with disability，years of life lost
Suggested Citation: Suggested Citation