Maternal Disorders among Women Aged 15 to 49 Years Global Trends, Inequalities, and Projections from the GBD Study 2021

Maternal Disorders among Women Aged 15 to 49 Years Global Trends, Inequalities, and Projections from the GBD Study 2021 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Maternal Disorders among Women Aged 15 to 49 Years Global Trends, Inequalities, and Projections from the GBD Study 2021 tianxiang Mai, Yang Bao, Guanqun Chao This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5848433/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 30 Aug, 2025 Read the published version in BMC Public Health → Version 1 posted 14 You are reading this latest preprint version Abstract Background Maternal disorders remain a pressing global health concern, especially in low-resource settings. Despite overall progress, persistent inequalities continue. This study examines the global burden of six maternal conditions—Maternal Hemorrhage, Maternal Sepsis and Other Maternal Infections, Maternal Hypertensive Disorders, Maternal Obstructed Labor and Uterine Rupture, Maternal Abortion and Miscarriage, and Ectopic Pregnancy—from 1990 to 2021, focusing on disease burden and disparities. Methods We used Global Burden of Disease Study 2021 data for women aged 15 to 49, analyzing disability-adjusted life years (DALYs) and incidence. The Sociodemographic Index (SDI) contextualized inequalities. Slope and concentration indices assessed disparities, while decomposition analyses explored drivers of DALY changes. Joinpoint regression and age-period-cohort analysis identified epidemiological shifts, and a Bayesian age-period-cohort model projected future incidence. Results Although absolute disparities in maternal disorders narrowed between 1990 and 2021, relative inequalities often increased. Low-SDI regions experienced slower declines or rises in burden, driven by demographic expansion offsetting epidemiological improvements. Decomposition analyses indicated that population growth remains a central barrier, while epidemiological gains substantially reduced DALYs. Projections suggest continued incidence declines, underscoring current intervention effectiveness but also persistent inequities. Conclusion Global maternal disorders have declined overall, yet inequalities have widened. Targeted interventions—such as improved maternal nutrition, education, reproductive health services, and enhanced screening—are crucial in low-SDI regions. Strengthening these measures can foster more equitable and sustainable maternal health outcomes, aligning with global efforts to reduce maternal morbidity and mortality. Maternal Disorders Incidence Disability-adjusted Life Years Global Burden Sociodemographic Index Trends Health Inequality Predictive Modeling Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Full Text Additional Declarations No competing interests reported. Supplementary Files TableS1.xlsx Table S1: DALYs and Incidences in Women Aged 15-49 of MD in 2021 by Different Characteristics. TableS2.xlsx Table S2: Age-standardized DALYs rates in 15-49 aged women of MH, MSI, MHD, MOLUR, MAM, and EP with slope index and concentration index of inequality analysis, categorized by 204 countries. TableS3.xlsx Table S3: Joinpoint regression analysis results in 15-49 aged women for MH, MSI, MHD, MOLUR, MAM, and EP, categorized by global and SDI regions. TableS4.xlsx Table S4: Age-standardized DALYs rates in 15-49 aged women of MH, MSI, MHD, MOLUR, MAM, and EP with decomposition analysis, categorized by global and SDI regions. TableS5.xlsx Table S5: Age-period analysis of Incidence in 15-49 aged women for MH, MSI, MHD, MOLUR, MAM, and EP based on disease burden from 1990 to 2021. TableS6.xlsx Table S6 BAPC Forecast of Incidences in 15-49 aged women for MH, MSI, MHD, MOLUR, MAM, and EP based on disease burden from 1990 to 2021,projected to 2044. TableS7.xlsx Table S7 NORDPRED Forecast of Incidences in 15-49 aged women for MH, MSI, MHD, MOLUR, MAM, and EP based on disease burden from 1992 to 2021,projected to 2044. Cite Share Download PDF Status: Published Journal Publication published 30 Aug, 2025 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 19 Jun, 2025 Reviews received at journal 07 Jun, 2025 Reviews received at journal 28 May, 2025 Reviewers agreed at journal 26 May, 2025 Reviewers agreed at journal 25 May, 2025 Reviewers agreed at journal 24 May, 2025 Reviewers agreed at journal 23 May, 2025 Reviewers agreed at journal 23 May, 2025 Reviewers agreed at journal 23 May, 2025 Reviews received at journal 15 May, 2025 Reviewers agreed at journal 05 May, 2025 Reviewers invited by journal 03 Apr, 2025 Submission checks completed at journal 26 Mar, 2025 First submitted to journal 23 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5848433","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":438022159,"identity":"3a43798e-a6e0-425b-a1f7-6c82841e4ed5","order_by":0,"name":"tianxiang Mai","email":"","orcid":"","institution":"Zhejiang University","correspondingAuthor":false,"prefix":"","firstName":"tianxiang","middleName":"","lastName":"Mai","suffix":""},{"id":438022160,"identity":"d1c26a00-1d73-4136-ac89-108835d3e32f","order_by":1,"name":"Yang Bao","email":"","orcid":"","institution":"Zhejiang University","correspondingAuthor":false,"prefix":"","firstName":"Yang","middleName":"","lastName":"Bao","suffix":""},{"id":438022161,"identity":"36d46e8b-480e-4136-a5aa-3b150431aad0","order_by":2,"name":"Guanqun Chao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIiWNgGAWjYDACCQST8QEDD4hOIF4LswHJWtigbAJa+Gc3P3z4tc0uj+9G7rHKHzKHGfjZcwwYfu7AY8mdY8bGsm3JxZI38tJuSPAcZpDseWPA2HsGtxYDiQQzack25sQNN3LMbhgAtRjcyDFgZmzDpyX9G1BLPVhLQQJQiz1hLTlmkh/bDoO1MBwA2SJBQIvEjZxiY4ZzxxNnnnljLNnAk84jceZZwcFePFr4Z6RvfPijrDqx73iO4cefPdZy/O3JGx/8xKMFBJjBEXgAiBl7GOBsvIDxB1zZD0JqR8EoGAWjYCQCAM3NUTFYgB0IAAAAAElFTkSuQmCC","orcid":"","institution":"Zhejiang University","correspondingAuthor":true,"prefix":"","firstName":"Guanqun","middleName":"","lastName":"Chao","suffix":""}],"badges":[],"createdAt":"2025-01-17 10:38:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5848433/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5848433/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-025-24228-4","type":"published","date":"2025-08-30T15:57:56+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":79885190,"identity":"09f5c5a7-714d-4ed2-9cb8-d8f266ba25dc","added_by":"auto","created_at":"2025-04-04 05:42:36","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":8513152,"visible":true,"origin":"","legend":"\u003cp\u003e(A) The Incidence rate of MD in 2021 for women aged 15-49 years across 204 countries and territories (per 100,000). (B) The DALYs rate of MD in 2021 for women aged 15-49 years across 204 countries and territories (per 100,000).DALYs, disability-adjusted life-years; MD, Maternal Disorders.\u003c/p\u003e","description":"","filename":"fig.1.png","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/16f55754b371907c18a89663.png"},{"id":79884205,"identity":"802ee6ac-a137-4ac0-98d3-48eea334294a","added_by":"auto","created_at":"2025-04-04 05:34:35","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":16170469,"visible":true,"origin":"","legend":"\u003cp\u003eHealth inequality regression curves and concentration curves for the DALYs of MH (A and B) , MSI (C and D), MHD (E and F), MOLUR (G and H), MAM (I and J), EP (K and L) worldwide, 1990 and 2021. Panels A, C, E, G, I, K illustrate the slope index of inequality, depicting the relationship between SDI and age-standardized DALYs rates for each condition, with points representing individual countries and territories sized by population. Panels B, D, F, H, J, Lpresent the concentration index, which quantifies relative inequalities by integrating the area under the Lorenz curve, aligning DALYs distribution with population distribution by SDI. Blue represents data from 1990, and red represents data from 2021. DALYs, disability-adjusted life-years; SDI, socio-demographic index; MH, Maternal Hemorrhage; MSI, Maternal Sepsis and Other Maternal Infections; MHD, Maternal Hypertensive Disorders; MOLUR, Maternal Obstructed Labor and Uterine Rupture; MAM, Maternal Abortion and Miscarriage; EP, Ectopic Pregnancy.\u003c/p\u003e","description":"","filename":"Fig.2.png","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/8448051aaaf5b9dc317c7eaa.png"},{"id":79884208,"identity":"34b775e9-e281-477b-8f37-56be5e639ca6","added_by":"auto","created_at":"2025-04-04 05:34:36","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":4733746,"visible":true,"origin":"","legend":"\u003cp\u003eTemporal trend changes in ASDR for MH (A), MSI (B), MHD (C), MOLUR (D), MAM (E), EP (F) globally and in various SDI regions from 1990 to 2021 based on the Joinpoint regression model. *p \u0026lt; 0.05; DALYs, disability-adjusted life-years;SDI, sociodemographic index; ASDR, age-standardized disability-adjusted life years rate; MH, Maternal Hemorrhage; MSI, Maternal Sepsis and Other Maternal Infections; MHD, Maternal Hypertensive Disorders; MOLUR, Maternal Obstructed Labor and Uterine Rupture; MAM, Maternal Abortion and Miscarriage; EP, Ectopic Pregnancy.\u003c/p\u003e","description":"","filename":"fig.3.png","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/ebc095a58638a216da5cb425.png"},{"id":79884225,"identity":"467f80b7-f338-4db6-a8ab-56f51b158e79","added_by":"auto","created_at":"2025-04-04 05:34:37","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":978715,"visible":true,"origin":"","legend":"\u003cp\u003ePopulation-level determinant changes in aging, population growth, and epidemiological changes for EP (A), MAM (B), MH(C), MHD (D), MOLUR (E), MSI(F) DALYs globally and in various SDI regions from 1990 to 2021. Black dots represent the total change contributed by all three components. A positive value for each component indicates a corresponding positive contribution in DALYs, and a negative value indicates a corresponding negative contribution in DALYs. DALYs, disability-adjusted life-years;SDI, sociodemographic index; MH, Maternal Hemorrhage; MSI, Maternal Sepsis and Other Maternal Infections; MHD, Maternal Hypertensive Disorders; MOLUR, Maternal Obstructed Labor and Uterine Rupture; MAM, Maternal Abortion and Miscarriage; EP, Ectopic Pregnancy.\u003c/p\u003e","description":"","filename":"fig.4.png","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/68f339bd7c0f8321ef7b058f.png"},{"id":79884216,"identity":"4cf23691-368f-46be-b8a6-73f401e12494","added_by":"auto","created_at":"2025-04-04 05:34:36","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":3623092,"visible":true,"origin":"","legend":"\u003cp\u003eAge-Period analysis on MSI (A), MH (B), MHD (C), MOLUR (D), EP (E), MAM(F) Incidence rate . Age effects are shown by the fitted longitudinal age curves of Incidence rate (per 100,000 populations).MH, Maternal Hemorrhage; MSI, Maternal Sepsis and Other Maternal Infections; MHD, Maternal Hypertensive Disorders; MOLUR, Maternal Obstructed Labor and Uterine Rupture; MAM, Maternal Abortion and Miscarriage; EP, Ectopic Pregnancy.\u003c/p\u003e","description":"","filename":"fig.5.png","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/eb6aa0e0dde6bde28b5152a4.png"},{"id":79885193,"identity":"dce08dcb-2891-4955-8207-badadcfb43aa","added_by":"auto","created_at":"2025-04-04 05:42:36","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":2313252,"visible":true,"origin":"","legend":"\u003cp\u003eTrends in age-standardized incidence rates per 100,000 women aged 15–49 years for MSI (A), MH (B), MHD (C), MOLUR (D), EP (E), MAM(F) by Bayesian age-period-cohort prediction model. MH, Maternal Hemorrhage; MSI, Maternal Sepsis and Other Maternal Infections; MHD, Maternal Hypertensive Disorders; MOLUR, Maternal Obstructed Labor and Uterine Rupture; MAM, Maternal Abortion and Miscarriage; EP, Ectopic Pregnancy.\u003c/p\u003e","description":"","filename":"fig.6.png","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/b9be037b4d97ee823fd88117.png"},{"id":90344942,"identity":"452811bb-fd93-40f7-9848-d8c10ecc1299","added_by":"auto","created_at":"2025-09-01 16:08:09","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":5504777,"visible":true,"origin":"","legend":"","description":"","filename":"MDnew.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1_covered_d8e6ee38-680c-455f-9a5f-c6df959d1409.pdf"},{"id":79884204,"identity":"3f6d5596-c17d-4013-bae6-5dcd6d75dbda","added_by":"auto","created_at":"2025-04-04 05:34:35","extension":"xlsx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":46137,"visible":true,"origin":"","legend":"\u003cp\u003eTable S1: DALYs and Incidences in Women Aged 15-49 of MD in 2021 by Different Characteristics.\u003c/p\u003e","description":"","filename":"TableS1.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/8b9a522e0610d0fdc16ee2da.xlsx"},{"id":79884223,"identity":"2ffc3877-4cdb-4e2c-bbb3-012e8b94afd8","added_by":"auto","created_at":"2025-04-04 05:34:36","extension":"xlsx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":10492,"visible":true,"origin":"","legend":"\u003cp\u003eTable S2: Age-standardized DALYs rates in 15-49 aged women of MH, MSI, MHD, MOLUR, MAM, and EP with slope index and concentration index of inequality analysis, categorized by 204 countries.\u003c/p\u003e","description":"","filename":"TableS2.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/bb2b7213ce7b4959a9cad889.xlsx"},{"id":79885191,"identity":"a23d8e6f-9230-4a9d-b388-a9be8292d7f8","added_by":"auto","created_at":"2025-04-04 05:42:36","extension":"xlsx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":22484,"visible":true,"origin":"","legend":"\u003cp\u003eTable S3: Joinpoint regression analysis results in 15-49 aged women for MH, MSI, MHD, MOLUR, MAM, and EP, categorized by global and SDI regions.\u003c/p\u003e","description":"","filename":"TableS3.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/3c2ed1807edb794eb0b5835e.xlsx"},{"id":79884213,"identity":"7b2c21a3-9ecd-4c7d-ae47-bd14d0fe6ed8","added_by":"auto","created_at":"2025-04-04 05:34:36","extension":"xlsx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":12593,"visible":true,"origin":"","legend":"\u003cp\u003eTable S4: Age-standardized DALYs rates in 15-49 aged women of MH, MSI, MHD, MOLUR, MAM, and EP with decomposition analysis, categorized by global and SDI regions.\u003c/p\u003e","description":"","filename":"TableS4.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/41ce025a85570454e2e6f1c3.xlsx"},{"id":79884206,"identity":"b2c4c8ca-ed59-4fa6-b8b5-5404b2f59f08","added_by":"auto","created_at":"2025-04-04 05:34:35","extension":"xlsx","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":15975,"visible":true,"origin":"","legend":"\u003cp\u003eTable S5: Age-period analysis of Incidence in 15-49 aged women for MH, MSI, MHD, MOLUR, MAM, and EP based on disease burden from 1990 to 2021.\u003c/p\u003e","description":"","filename":"TableS5.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/512a9f53056f238ce5d8129f.xlsx"},{"id":79884232,"identity":"c51e0095-02bf-459f-a95b-cd2d9c11059b","added_by":"auto","created_at":"2025-04-04 05:34:37","extension":"xlsx","order_by":6,"title":"","display":"","copyAsset":false,"role":"supplement","size":189286,"visible":true,"origin":"","legend":"\u003cp\u003eTable S6 BAPC Forecast of Incidences in 15-49 aged women for MH, MSI, MHD, MOLUR, MAM, and EP based on disease burden from 1990 to 2021,projected to 2044.\u003c/p\u003e","description":"","filename":"TableS6.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/783561df76824737654fdb92.xlsx"},{"id":79884211,"identity":"631b71f3-94a9-4b89-b9c6-c4a573b40bc1","added_by":"auto","created_at":"2025-04-04 05:34:36","extension":"xlsx","order_by":7,"title":"","display":"","copyAsset":false,"role":"supplement","size":110730,"visible":true,"origin":"","legend":"\u003cp\u003eTable S7 NORDPRED Forecast of Incidences in 15-49 aged women for MH, MSI, MHD, MOLUR, MAM, and EP based on disease burden from 1992 to 2021,projected to 2044.\u003c/p\u003e","description":"","filename":"TableS7.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-5848433/v1/186c448a4431e1e91386002d.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Maternal Disorders among Women Aged 15 to 49 Years Global Trends, Inequalities, and Projections from the GBD Study 2021","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Maternal Disorders, Incidence, Disability-adjusted Life Years, Global Burden, Sociodemographic Index, Trends, Health Inequality, Predictive Modeling","lastPublishedDoi":"10.21203/rs.3.rs-5848433/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5848433/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e \u003cb\u003eBackground\u003c/b\u003e Maternal disorders remain a pressing global health concern, especially in low-resource settings. Despite overall progress, persistent inequalities continue. This study examines the global burden of six maternal conditions\u0026mdash;Maternal Hemorrhage, Maternal Sepsis and Other Maternal Infections, Maternal Hypertensive Disorders, Maternal Obstructed Labor and Uterine Rupture, Maternal Abortion and Miscarriage, and Ectopic Pregnancy\u0026mdash;from 1990 to 2021, focusing on disease burden and disparities.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMethods\u003c/b\u003e We used Global Burden of Disease Study 2021 data for women aged 15 to 49, analyzing disability-adjusted life years (DALYs) and incidence. The Sociodemographic Index (SDI) contextualized inequalities. Slope and concentration indices assessed disparities, while decomposition analyses explored drivers of DALY changes. Joinpoint regression and age-period-cohort analysis identified epidemiological shifts, and a Bayesian age-period-cohort model projected future incidence.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e Although absolute disparities in maternal disorders narrowed between 1990 and 2021, relative inequalities often increased. Low-SDI regions experienced slower declines or rises in burden, driven by demographic expansion offsetting epidemiological improvements. Decomposition analyses indicated that population growth remains a central barrier, while epidemiological gains substantially reduced DALYs. Projections suggest continued incidence declines, underscoring current intervention effectiveness but also persistent inequities.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusion\u003c/b\u003e Global maternal disorders have declined overall, yet inequalities have widened. Targeted interventions\u0026mdash;such as improved maternal nutrition, education, reproductive health services, and enhanced screening\u0026mdash;are crucial in low-SDI regions. Strengthening these measures can foster more equitable and sustainable maternal health outcomes, aligning with global efforts to reduce maternal morbidity and mortality.\u003c/p\u003e","manuscriptTitle":"Maternal Disorders among Women Aged 15 to 49 Years Global Trends, Inequalities, and Projections from the GBD Study 2021","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-04 05:34:29","doi":"10.21203/rs.3.rs-5848433/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-19T09:32:42+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-07T17:18:48+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-28T16:06:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"91074073252046574044964269841072091755","date":"2025-05-26T13:39:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"336830509026096029934010368163194990094","date":"2025-05-26T03:30:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"23167366528998083646231252626220120373","date":"2025-05-24T08:53:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"9181435376345132786740728683009095947","date":"2025-05-23T08:08:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"273837175513296702142274623948377604522","date":"2025-05-23T06:55:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"181383574705460452146972506207083969005","date":"2025-05-23T05:28:48+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-15T18:45:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"289713991142509067706624823686963928419","date":"2025-05-05T18:29:45+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-03T05:55:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-26T06:46:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-03-23T05:55:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"66c64fe6-4838-4141-85ad-014a6344e3bd","owner":[],"postedDate":"April 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-01T16:02:20+00:00","versionOfRecord":{"articleIdentity":"rs-5848433","link":"https://doi.org/10.1186/s12889-025-24228-4","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2025-08-30 15:57:56","publishedOnDateReadable":"August 30th, 2025"},"versionCreatedAt":"2025-04-04 05:34:29","video":"","vorDoi":"10.1186/s12889-025-24228-4","vorDoiUrl":"https://doi.org/10.1186/s12889-025-24228-4","workflowStages":[]},"version":"v1","identity":"rs-5848433","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5848433","identity":"rs-5848433","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}