Abstract
BACKGROUND: Maternal sepsis and other maternal infections (MSMIs) significantly contribute to maternal morbidity and mortality worldwide, posing critical challenges due to their rapid progression and severe outcomes. METHODS: Data from the Global Burden of Disease (GBD) 2021 study, covering 204 countries and territories, were used to evaluate the incidence, death, and disability-adjusted life years (DALYs) of MSMI. Statistical methods included joinpoint regression, age-period-cohort analysis, decomposition analysis, frontier analysis, and ARIMA model forecasting. RESULTS: From 1990 to 2021, global MSMI incidence decreased from 22.45 million to 19.05 million, with the age-standardized rate (ASR) dropping from 764.03 (95% UI: 573.01-970.54) to 494.19 (95% UI: 377.34-623.90) per 100,000 people. High-SDI regions saw significant reductions, while low-SDI regions experienced increases. Women aged 20-24 consistently had the highest incidence, death, and DALYs. Iron deficiency was a significant risk factor, especially in lower SDI regions. Decomposition analysis showed that epidemiological changes and population growth were major drivers, particularly in low-SDI regions. Age-period-cohort analysis revealed women aged 20-29 as the most vulnerable, with notable improvements after 2000 and progressively decreasing risks in younger cohorts. Frontier analysis revealed that higher-SDI countries had greater improvement potential. ARIMA forecasting suggests continued declines in MSMI cases and ASR through 2040. CONCLUSIONS: While significant progress has been made globally, challenges persist, including rising incidence in low-SDI regions, vulnerability of women aged 20-29, and the impact of iron deficiency. Efforts to address these and improve healthcare infrastructure are critical to further reduce MSMI and enhance maternal health outcomes.