Abstract
BACKGROUND: Heart failure in childbearing females aged 15-49 years has shown a steady global increase, with prevalence rising from 1.74 million cases in 1990 to 3.09 million cases in 2021, largely driven by metabolic dysfunction, pregnancy-related complications, and demographic shifts. This study evaluates temporal trends and projections of heart failure burden in this population using data from the Global Burden of Disease (GBD) Study 2021. METHODS: Data on heart failure prevalence, years lived with disability (YLDs), and age-standardized rates (ASRs) were extracted from GBD 2021 for females aged 15-49 years. Linear regression analysis assessed temporal trends (1990-2021), while Bayesian age-period-cohort, autoregressive integrated moving average, and exponential smoothing models projected future burdens (2022-2050). Decomposition analysis quantified contributions from population growth, aging, and epidemiological changes. RESULTS: In 2021, heart failure affected 3.09 million childbearing females (age-standardized prevalence rate: 156.9/100,000), contributing to 297,261 YLDs (age-standardized YLDs rate: 15.1/100,000). Burden varied by age, peaking in 45-49 year-olds, and region, with middle Socio-demographic Index regions reporting the highest absolute cases and low-SDI regions the highest ASRs. From 1990-2021, the disease burden increased. Projections indicate a rise in prevalence and YLDs by 2050, with South Asia and sub-Saharan Africa facing appeared to increase the most. China showed the most rapid growth, while Bolivia and Sweden reported declines. CONCLUSION: Heart failure burden in childbearing females is rising globally, particularly in low- and middle-income countries. The observed increasing trends highlight the need for improved maternal care and equitable healthcare access across regions.