Global, regional, and national trends in the epidemiology of aortic aneurysms among women of childbearing age, 1990-2021, with predictions through 2036.

BACKGROUND

Aortic aneurysms (AA) pose a significant risk to women of childbearing age due to the added physiological stress of pregnancy and hormonal changes. This study aims to assess the global disease burden of AA among women of childbearing age from 1990 to 2021, project future trends, and provide evidence-based insights to inform public health policies and clinical decision-making.

METHODS

Aortic aneurysm mortality and disability-adjusted life years (DALYs) data for women of childbearing age (15-49 years) from 1990 to 2021 were extracted from the 2021 Global Burden of Disease (GBD) dataset. Temporal trends and attributable risks were evaluated using estimated annual percentage change (EAPC) and linear regression model from 1990 to 2021. Cluster analysis identified patterns across GBD regions. The Socio-demographic Index (SDI) assessed regional and national differences in mortality and DALYs rates related to AA. In addition, all potential risk determinants associated with AA were systematically examined. An age-period-cohort model assessed trends, period, and cohort effects, while the Bayesian age-period-cohort model predicted the disease burden through 2036.

RESULTS

In 2021, AA was associated with 2,552 (95% UI: 2,273 to 2,827) mortality and 86,466 (95% UI: 72,510 to 115,049) DALYs counts worldwide among women of childbearing age. The age-standardized mortality rate (ASMR) and age-standardized DALYs rate for AA decreased from 1.58 (95% UI: 1.41 to 1.76) to 1.28 (95% UI: 1.10 to 1.42), and from 28.52 (95% UI: 25.56 to 32.53) to 23.01 (95% UI: 20.49 to 25.27), respectively, between 1990 and 2021. By SDI quintile, the EAPC for both mortality and DALYs increased in the low-middle and middle SDI regions. Using the average age, period, and cohort as reference groups, the risk of AA death increased with age [RR  = 0.026 to RR  = 0.384]. The risk of DALYs followed a similar age-related trend. Among the risk factors associated with AA, mortality counts and DALYs attributable to smoking declined over time, whereas those related to high systolic blood pressure and high body mass index (BMI) showed increasing trends. Predicted results indicate that mortality and DALY rates among women of childbearing age are expected to continue declining from 2022 to 2036.

CONCLUSIONS

Although the global burden of AA among women of childbearing age is decreasing, significant regional disparities persist, and the rising prevalence of hypertension and high BMI poses ongoing challenges. Strengthened prevention strategies targeting modifiable risk factors are urgently needed to further reduce disease burden and promote health equity.