Epidemiological Trends of Maternal Hypertensive Disorders of Pregnancy at the Global, Regional, and National Levels: A Population-Based Study

Abstract Background. To report the cause-specific prevalence and trends of hypertensive disorders of pregnancy at global, regional and national levels from 1990 to 2019 by age and sociodemographic index.Methods. For hypertensive disorders of pregnancy, point prevalence, annual incidence, and years lived with disability numbers and age standardized rates per 100,000 population were compared across regional and national levels by age and sociodemographic index using data from the global Burden of Disease 2019 Study. Estimates are reported with uncertainty intervals.Results. The incidence of hypertensive disorders of pregnancy increased from 16.30 million to 18.08 million globally, with a total increase of 10.92% from 1990 to 2019. The age-standardized incidence rate decreased, with an estimated annual percentage change of -0.68 (95% CI -0.49 to -0.86). The number of deaths due to hypertensive disorders of pregnancy was approximately 27.83 thousand in 2019. This was a 30.05% decreased from 1990. Based on the incidence and prevalence, the number of deaths and years lived with disability were highest in the group aged 25-29 years, followed by the groups aged 30-34 and 20-24 years, while the estimated incidence rate was lowest in the group aged 25-29 years and higher in the youngest and oldest groups. Positive associations between incidence and sociodemographic index and human development index were found for all countries and regions in 2019. Age-standardized incidence rates were higher in countries/regions with lower sociodemographic indices and human development indices.Conclusion. Our study provides a comprehensive overview of the global burden of hypertensive disorders of pregnancy. The death and incidence burdens are decreasing in most countries and all regions except low-sociodemographic and -human development index areas. This is mainly because attention to prenatal examinations and health education has increased. Further investigations should focus on forecasting the global disease burden of specific hypertensive disorders of pregnancy and modifiable risk factors.