This ecological analysis used Global Burden of Disease (GBD) 2021 data to quantify the worldwide impact of maternal sepsis and other maternal infections (MSMI) from 1990 through 2021 and to project trends to 2050. The authors report that MSMI accounted for approximately 10.7% of maternal deaths globally. The report emphasizes that, despite overall declines, a substantial and persistent burden remains concentrated in low- and low-middle Socio-demographic Index (SDI) regions.
The study extracted incidence, mortality, and disability-adjusted life years (DALYs), along with their age-standardized rates (ASR), from the GBD 2021 dataset for global, regional, and national comparisons. Coverage included 21 GBD regions and 204 countries and territories. To evaluate associations between MSMI burden and socio-demographic development, the authors applied locally weighted regression and Spearman correlation against the SDI.
Attributable risk burdens were estimated using the GBD comparative risk assessment framework, identifying contributing risk factors by SDI strata. For temporal forecasting to 2050, the authors used an autoregressive integrated moving average (ARIMA) model to project future trajectories of incidence, mortality, and DALYs.
The PubMed abstract provides an overview of these methods but does not include detailed model parameters, specific ASR values, country-level estimates, or uncertainty intervals; those details were not reported in the source abstract.
Overall, the global burden of MSMI showed a declining trend between 1990 and 2021 according to the GBD-derived metrics. Age-specific patterns indicated the highest burden in women aged 20–29 years. While incidence and DALYs decreased over time, the trajectory for mortality was less certain, and the authors note that mortality trends may not mirror declines seen for other burden measures.
A major finding is the pronounced inverse association between MSMI burden and SDI. High-SDI regions had low MSMI burden that approached negligible levels in recent years. In contrast, low-SDI regions experienced persistently high burden with slower declines over the study period. The authors highlight substantial regional disparities across the 21 GBD regions and 204 countries/territories analyzed.
Using the GBD comparative risk assessment framework, the analysis identified differing drivers of MSMI burden across SDI strata. In low-SDI regions, maternal malnutrition and iron deficiency were major contributors to attributable risk for MSMI. The abstract notes that behavioral risk factors played a limited role in high-SDI regions. The specific attributable fractions or ranking of other risk factors are not detailed in the abstract and therefore are not reported here.
The ARIMA-based projections reported in the abstract indicate continued declines in MSMI incidence and DALYs through the projection period to 2050. However, projected mortality trends were characterized as uncertain, suggesting that reductions in mortality may lag or vary by region and that model forecasts for deaths lack clear direction in the abstract summary.
The abstract does not supply numeric projection outputs, confidence intervals, or country-level forecasts from the ARIMA model; those specifics were not reported in the source abstract.
Despite global reductions in incidence and DALYs, the disproportionate and persistent burden of MSMI in low- and low-middle SDI settings underscores the need for prioritized interventions in those regions. The authors recommend strengthening measures that include early identification of maternal infections and sepsis, standardized clinical treatment pathways, robust infection prevention and control practices, and targeted nutritional interventions to address malnutrition and iron deficiency. These strategies aim to reduce both the incidence and the adverse outcomes associated with MSMI where the need is greatest.
The PubMed abstract outlines the study objectives, methods, and high-level results but omits many granular details. The abstract does not report specific age-standardized rates, numerical country-level estimates, model parameterization for the ARIMA forecasts, uncertainty intervals, or the full list and quantitative ranking of attributable risks. Where the abstract lacks such data, those details were not reported in the source and therefore are not included in this summary.
Overall, the GBD 2021-based analysis provides an overview of global trends and drivers of maternal sepsis and other maternal infections, showing continued improvement in many settings but persistent inequities that require sustained clinical and public health action, particularly in low-SDI regions.