The global burden of maternal disorders attributable to iron deficiency related sub-disorders in 204 countries and territories: an analysis for the Global Burden of Disease study

Abstract

Background: Pregnancy-related anemia presents a significant health concern for approximately 500 million women of reproductive age worldwide. To better prevent maternal disorders, it is essential to understand the impact of iron deficiency across different maternal disorders, regions, age groups, and subcategories.

Methods: Based on the comprehensive maternal disorders data sourced from the 2019 Global Burden of Disease study, an investigation was carried out focusing on Disability-Adjusted Life Years (DALYs) associated with iron deficiency spanning the period from 1990 to 2019. In addition, Estimated Annual Percentage Changes (EAPCs) were computed for the duration of the study.

Results: Our study indicates decreasing mortality rates and years of life lost due to maternal conditions related to iron deficiency, such as maternal hemorrhage, miscarriage, abortion, hypertensive disorders, and infections. However, mortality rates and years of life lost due to indirect and late maternal deaths, as well as deaths aggravated by HIV/AIDS, have increased in high socio-demographic index (SDI) regions, especially in North America. Moreover, the proportion of maternal deaths aggravated by HIV/AIDS due to iron deficiency is rising globally, especially in Southern Sub-Saharan Africa, Oceania, and Georgia. In addition, in the Maldives, the age-standardized DALYs for maternal disorders attributable to iron deficiency exhibited a notable decreasing trend, encompassing a range of conditions. Furthermore, there was a significant decrease in Disability-Adjusted Life Years rate for miscarriages and preterm births among women aged 15-49, with hypertensive disorders posing the highest burden among women aged 15-39.

Conclusion: The burden of maternal disorders caused by iron deficiency is decreasing in most regions and subtypes, except for deaths aggravated by HIV/AIDS. By thoroughly understanding the details of how iron deficiency impacts the health of pregnant women, health policymakers, healthcare professionals, and researchers can more effectively pinpoint and address the root causes of inequalities in maternal health.

Keywords: Disability-Adjusted Life Years; Estimated Annual Percentage Changes; GBD 2019; iron deficiency; maternal disorders.

Figure 1

The temporal trends in the burden of iron deficiency on maternal disorders from 1990 to 2019.

Figure 2

The proportion of maternal disorders contribution to iron deficiency across GBD regions between 1990 and 2019.

Figure 3

The EAPC of age-standardized DALYs for maternal disorders caused by iron deficiency across 204 countries. (A) The EAPC of age-standardized DALYs for ectopic pregnancy caused by iron deficiency across 204 countries. (B) The EAPC of age-standardized DALYs for indirect maternal deaths caused by iron deficiency across 204 countries. (C) The EAPC of age-standardized DALYs for maternal sepsis and other maternal infections caused by iron deficiency across 204 countries. (D) The EAPC of age-standardized DALYs for late maternal deaths caused by iron deficiency across 204 countries. (E) The EAPC of age-standardized DALYs for maternal deaths aggravated by HIV/AIDS caused by iron deficiency across 204 countries. (F) The EAPC of age-standardized DALYs for maternal hypertensive disorders caused by iron deficiency across 204 countries. (G) The EAPC of age-standardized DALYs for maternal abortion and miscarriage caused by iron deficiency across 204 countries. (H) The EAPC of age-standardized DALYs for maternal hemorrhage caused by iron deficiency across 204 countries. (I) The EAPC of age-standardized DALYs for maternal obstructed labor and uterine rupture caused by iron deficiency across 204 countries.

Figure 4

Contributions of iron deficiency to the burden of maternal disorders by age group from 1990 to 2019. (A) Contributions of iron deficiency to the burden of ectopic pregnancy by age group from 1990 to 2019. (B) Contributions of iron deficiency to the burden of indirect maternal deaths by age group from 1990 to 2019. (C) Contributions of iron deficiency to the burden of maternal sepsis and other maternal infections by age group from 1990 to 2019. (D) Contributions of iron deficiency to the burden of late maternal deaths by age group from 1990 to 2019. (E) Contributions of iron deficiency to the burden of maternal deaths aggravated by HIV/AIDS by age group from 1990 to 2019. (F) Contributions of iron deficiency to the burden of maternal hypertensive disorders by age group from 1990 to 2019. (G) Contributions of iron deficiency to the burden of maternal abortion and miscarriage by age group from 1990 to 2019. (H) Contributions of iron deficiency to the burden of maternal hemorrhage by age group from 1990 to 2019. (I)Contributions of iron deficiency to the burden of maternal obstructed labor and uterine rupture by age group from 1990 to 2019.