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. 2025 Jun 5;22(1):97.
doi: 10.1186/s12978-025-02049-3.

Epidemiological trends in abortion and miscarriage between 1990 and 2019

Yadi Wang #  1   2 , Yujie Tang #  1   2 , Guoshuai Wang #  1   2 , Ran Wei  1   2 , Lu Liu  1   2 , Chao Lu  3   4
Affiliations

Epidemiological trends in abortion and miscarriage between 1990 and 2019

Yadi Wang et al. Reprod Health. .
No abstract available

Keywords: Abortion; Disability-adjusted life-years; Global burden of disease; Social development index.

Plain language summary

Abortion and miscarriage both lead to pregnancy loss. Unsafe abortion, in particular, greatly impairs maternal reproductive health. Understanding the burden and epidemiological trends of abortion and miscarriage is essential for informing public health strategies. In this study, we used the Global Burden of Disease Study (GBD) 2019 to comprehensively analyse the burden of abortion and miscarriage from 1990 to 2019. Although our study observed a global decline in incidence from 1990 to 2019, abortion and miscarriage remains significant reproductive health concerns in low-SDI countries. The low-SDI had much greater age-standardized rates of incidence, deaths and DALYs than the other SDI quintiles. Globally, a high incidence was observed for women aged 20 to 29 years, and a greater number of deaths was recorded for women aged 35 to 44 years.Our study may provide useful theoretical data for reproductive health interventions. Studying the epidemiology of abortion and miscarriage, identifying key risk factors and regional disparities, can enable healthcare systems to implement targeted interventions to protect reproductive health effectively.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. This study does not contain data from any individual person. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The incidence of abortion and miscarriage in 204 countries and territories. A The age-standardized incidence rate (ASIR) of abortion and miscarriage in 2019. B The percent change in incidence cases of abortion and miscarriage from 1990 to 2019. C The estimated annual percentage change (EAPC) of abortion and miscarriage in ASIR from 1990 to 2019
Fig. 2
Fig. 2
Trends of ASIRs, ASDRs and age-standardized DALY rates by sociodemographic index (SDI). The age-standardized incidence (A), death (B), DALY (C), prevalence (D), YLL (E), YLD (F) rate of abortion and miscarriage by year (1990 and 2019). Trends in the number of incidence (G), death (H), DALY (I), prevalence (J), YLL (K), YLD (L) cases of abortion and miscarriage from 1990 to 2019. DALY: disability-adjusted life-year; YLL: year of life lost; YLD: year lived with disability
Fig. 3
Fig. 3
Trends of ASIRs, ASDRs and age-standardized DALY rates in the 21 GBD regions. The age-standardized incidence (A), death (B), DALY (C), prevalence (D), YLL (E), YLD (F) rate of abortion and miscarriage compared between 1990 and 2019. Trends in the number of incidence (G), death (H), DALY (I), prevalence (J), YLL (K), YLD (L) cases of abortion and miscarriage from 1990 to 2019. DALY: disability-adjusted life-year; YLL: year of life lost; YLD: year lived with disability
Fig. 4
Fig. 4
Trends of ASIRs, ASDRs and age-standardized DALY rates in different income areas. The age-standardized incidence (A), death (B), DALY (C), prevalence (D), YLL (E), YLD (F) rate of abortion and miscarriage by year (1990 and 2019). Trends in the number of incidence (G), death (H), DALY (I), prevalence (J), YLL (K), YLD (L) cases of abortion and miscarriage from 1990 to 2019. DALY: disability-adjusted life-year; YLL: year of life lost; YLD: year lived with disability
Fig. 5
Fig. 5
Trends of ASIRs, ASDRs and age-standardized DALY rates by age group. The populations were divided into six age groups: 15–19 years, 20–24 years, 25–29 years,30–34 years,35–39 years, 40–44 years. The number of incidence (A), death (B), DALY (C) cases of abortion and miscarriage by age groups in 2019. The number of incidence (D), death (E), DALY (F) cases of abortion and miscarriage by age groups in 1990. The proportion (%) of the six age groups in the total incidence cases (G). The proportion (%) of the six age groups in the total death cases (H). Trends in the number of incidence (I), death (J), DALY (K), prevalence (L), YLL (M), YLD (N) cases of abortion and miscarriage by six age groups from 1990 to 2019. DALY: disability-adjusted life-year; YLL: year of life lost; YLD: year lived with disability
Fig. 6
Fig. 6
The death burden attributable to risk factor (iron deficiency) for abortion and miscarriage. A The age-standardized death rate (ASDR) of abortion and miscarriage attributable to iron deficiency globally and in five SDI quintiles in 2019. B The age-standardized death rate (ASDR) of abortion and miscarriage attributable to iron deficiency in 21GBD regions in 2019. C The age-standardized death rate (ASDR) of abortion and miscarriage attributable to iron deficiency in different income areas in 2019. D Trends in the number of deaths of abortion and miscarriage attributable to iron deficiency globally and in five SDI quintiles from 1990 to 2019. E Trends in the number of deaths of abortion and miscarriage attributable to iron deficiency in 21GBD regions from 1990 to 2019. F Trends in the number of deaths of abortion and miscarriage attributable to iron deficiency in different income areas from 1990 to 2019. The proportion of the six age groups for iron deficiency-related deaths globally (G), and in high (H), high middle (I), middle (J), low middle (K), and low SDI quintiles (L) in 2019
Fig. 7
Fig. 7
The correlation between the sociodemographic index (SDI) and the age-standardized rate of abortion and miscarriage for 21 GBD regions, 1990–2019. A Age-standardized incidence rate (ASIR). B Age-standardized death rate (ASDR). Lines in the same colour and pattern represent the age-standardized rate of a region, each point in a line represents 1 year starting at 1990 and ending at 2019. The black line represents the average expected relationship between SDI and age-standardized rates for abortion and miscarriage, according to values for each geographic region from 1990–2019
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