Global disability-adjusted life years and deaths attributable to child and maternal malnutrition from 1990 to 2019

Abstract

Background: Child and maternal malnutrition (CMM) caused heavy disability-adjusted life years (DALY) and deaths globally. It is crucial to understand the global burden associated with CMM in order to prioritize prevention and control efforts. We performed a comprehensive analysis of the global DALY and deaths attributable to CMM from 1990 to 2019 in this study.

Methods: The age-standardized CMM related burden including DALY and death from 1990 to 2019 were accessed from the Global Burden of Disease study 2019 (GBD 2019). The changing trend were described by average annual percentage change (AAPC). The relationship between sociodemographic factors and burden attributable to CMM were explored by generalized linear model (GLM).

Results: Globally, in 2019, the age-standardized DALY and death rates of CMM were 4,425.24/100,000 (95% UI: 3,789.81/100,000-5,249.55/100,000) and 44.72/100,000 (95% UI: 37.83/100,000-53.47/100,000), respectively. The age-standardized DALY rate (AAPC = -2.92, 95% CI: -2.97% to -2.87%) and death rates (AAPC = -3.19, 95% CI: -3.27% to -3.12%) presented significantly declining trends during past 30 years. However, CMM still caused heavy burden in age group of <28 days, Sub-Saharan Africa and low SDI regions. And, low birth weight and short gestation has identified as the primary risk factors globally. The GLM indicated that the highly per capita gross domestic product, per capita current health expenditure, physicians per 1,000 people were contributed to reduce the burden attributable to CMM.

Conclusion: Although global burden attributable to CMM has significantly declined, it still caused severe health burden annually. To strengthen interventions and address resources allocation in the vulnerable population and regions is necessary.

Keywords: child and maternal malnutrition; global burden of disease; low SDI; sub-Saharan Africa; trends.

Figure 1

Global burden attributable to CMM in 2019 and average annual percentage change of age-standardized rates from 1990 to 2019. (A) Age-standardized DALY rate in 2019; (B) ASDR in 2019; (C) AAPC of age-standardized DALY rate from 1990 to 2019; (D) AAPC of ASDR from 1990 to 2019. ASR: age-standardized rate. An AAPC less than 0 indicates a significant decrease, an AAPC equal to 0 signifies stability, and an AAPC greater than 0 represents a significant increase.

Figure 2

Age-standardized DALY and death rate attributable to CMM among SDI quintiles from 1990 to 2019. (A) Global; (B) High SDI; (C) High-middle SDI; (D) Middle-SDI; (E) Low middle SDI; (F) Low SDI.

Figure 3

Contribution of each specific risk factor for DALY and death of global and each SDI regions. (A) DALY; (B) Death.

Figure 4

Global burden attributable to low birth weight and short gestation in 2019. (A) Age-standardized DALY rate of low birth weight and short gestation; (B) Age-standardized DALY rate of low birth weight; (C) Age-standardized DALY rate of short gestation; (D) ASDR of low birth weight and short gestation; (E) ASDR of low birth weight; (F) ASDR of short gestation.

Figure 5

The correlation between SDI scores and the age-standardized rates of DALY and death in 21 GBD regions. (A) The correlation between SDI scores and the age-standardized DALY rate; (B) The correlation between SDI scores and ASDR. The horizontal axis represents the score of the social development index, ranging from 0 for low to 1 for high. Meanwhile, the vertical axis represents the age-standardized rates of DALY and death, with distinct shapes denoting different GBD regions.