Burden of Hypertensive Disorders of Pregnancy: A Trend Study from 1990 to 2021 with Risk Factor and Dietary Analysis

Abstract

Background: Hypertensive disorders of pregnancy (HDP), the third leading cause of maternal mortality worldwide, account for approximately 16% of all maternal deaths. The incidence and mortality rates of HDP vary across regions. Objective: This study was aimed at examining global trends in HDP prevalence from 1990 to 2021, identifying major risk factors associated with HDP-related mortality, and assessing the influence of dietary habits on HDP risk. Methods: Using data from the 2021 global burden of disease (GBD) study, we conducted a cross-sectional analysis across 204 countries and 21 regions. The estimated annual percentage change was used to evaluate trends in incidence, disability-adjusted life years (DALYs), and mortality associated with HDP. Mendelian randomization analysis was applied to investigate the causal relationships between dietary habits and HDP risk. In addition, projections of HDP prevalence were made through 2035 according to GBD data. Results: Although the absolute number of HDP cases has risen, HDP incidence, DALYs, and mortality rates have declined globally. Regional, age-related, and socioeconomic disparities persist, and low-income countries are disproportionately affected because of limited healthcare resources. Behavioral risks, maternal and child malnutrition, and iron deficiency were identified as risk factors for HDP-related mortality. Conclusions: Despite the overall decline in HDP incidence, DALYs, and mortality rates over the past 3 decades, the persistent high burden in low socio-demographic index regions highlights the urgent need for targeted health interventions. Addressing broader socioeconomic determinants is essential to sustainably decrease the global effects of HDP.

Keywords

global burden of disease / hypertensive disorders of pregnancy / incidence rates / disability-adjusted life years / mortality rates

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