Assessment of the Burden of Maternal Hypertensive Disorders and the Quality of Care in China: A Systematic Analysis of the Global Burden of Disease (GBD) 2021 Study

Abstract

Objectives This study aims to analyze the disease burden and quality of care associated with maternal hypertensive disorders in China over time and across age groups from 1990 to 2021. Methods This study employs statistical methods, including joinpoint regression analysis, decomposition analysis, age-period-cohort analysis, and the quality-of-care index, to assess the disease burden of maternal hypertensive disorders in China between 1990 and 2021. It uses an ARIMA model to forecast the disease burden for the period 2022–2035. Results Compared with 1990, the decline in the number of deaths, death rate, number of DALYs, and DALYs rate in 2021 was over 80% in each case, at 89.66%, 87.50%, 84.97% and 82.97%, respectively; the decline in the number and rate of prevalence, as well as the number and rate of incidence, ranged between 35% and 45%. The burden of disease has shifted from the 20–24 age group to the 30–34 age group (peak in number of cases) or the 25–29 age group (peak in rates). ARIMA forecasts that these rates will continue to decline through to 2035, although the rate of decline in incidence and prevalence will slow. The quality-of-care index rose steadily from 2003 to 2021. Conclusion The overall burden of maternal hypertensive disorders in China is declining. Based on the observed epidemiological trends: the quality of care is relatively low among both younger and older age groups; blood pressure management across the entire reproductive lifespan could be optimized in the future.