---
title: "Global burden and trends of maternal sepsis and infections (1990–2021) with projections to 2050"
id: "pubmed-42683240"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42683240"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42683240/"
doi: "10.1515/med-2026-1443"
published_at: "2026-09-02T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Global burden and trends of maternal sepsis and infections (1990–2021) with projections to 2050
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42683240
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42683240/)
- **DOI:** [10.1515/med-2026-1443](https://doi.org/10.1515%2Fmed-2026-1443)
- **Published At:** 2026-09-02T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The study quantifies the global burden of **maternal sepsis and other maternal infections (MSMI)** using GBD 2021 data, covering incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021 and projecting to 2050. - In 2021 MSMI accounted for about **10.7%** of maternal deaths worldwide, with the greatest burden concentrated in low- and low-middle Socio-demographic Index (**SDI**) regions. - The analysis included 21 Global Burden of Disease regions and 204 countries and territories; outcomes were evaluated as absolute burden and age-standardized rates (ASR). - Methods used: locally weighted regression and Spearman correlation to assess associations with **SDI**; attributable risk estimated via the GBD comparative risk assessment framework; temporal projections used an **ARIMA** model. - Key findings: burden is inversely associated with SDI, peaked in the 20–29 age group, and showed regional disparities—high-SDI regions had low, nearing-negligible burden, while low-SDI regions had persistently high burden with slow declines. - Major attributable risks differed by SDI: **maternal malnutrition** and **iron deficiency** were important contributors in low-SDI regions; behavioral factors had limited impact in high-SDI regions. - ARIMA projections forecast continued declines in incidence and DALYs, but projected mortality trends were uncertain. - Authors conclude that despite global declines, low-income and low-middle income regions still carry disproportionate MSMI burden and call for strengthened early identification, standardized treatment, infection prevention and control, and nutritional interventions. - The abstract does not report detailed numerical ASR values, country-specific estimates, model parameters, confidence intervals, or full methodological specifics in the PubMed abstract; those details are not reported in the source abstract.
## Clinical Analysis & Structured Key Points
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China."), [Linzi Lei](https://pubmed.ncbi.nlm.nih.gov/?term=Lei+L&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-3 "School of Public Health, Xiamen University, Xiamen, P.R. China.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-4 "Jurong Health Supervision Institute, Jurong, P.R. China."), [Xiyang Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+X&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-3 "School of Public Health, Xiamen University, Xiamen, P.R. China."), [Qingchen Cui](https://pubmed.ncbi.nlm.nih.gov/?term=Cui+Q&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-3 "School of Public Health, Xiamen University, Xiamen, P.R. China."), [Xiaolei Ji](https://pubmed.ncbi.nlm.nih.gov/?term=Ji+X&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-3 "School of Public Health, Xiamen University, Xiamen, P.R. China."), [Shuai Deng](https://pubmed.ncbi.nlm.nih.gov/?term=Deng+S&cauthor_id=42683240)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-5 "Health Team, Mobile Detachment of Shanxi Provincial Corps of the Chinese People's Armed Police Force, Taiyuan, P.R. China."), [Jianhua Yu](https://pubmed.ncbi.nlm.nih.gov/?term=Yu+J&cauthor_id=42683240)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-1 "Department of Critical Care Medicine, Xiamen Humanity Hospital, Xiamen, P.R. China."), [Youzhu Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+Y&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#full-view-affiliation-6 "College of Animal Science and Technology, China Agricultural University, Beijing, P.R. China.") Affiliations Expand ### Affiliations * 1 Department of Critical Care Medicine, Xiamen Humanity Hospital, Xiamen, P.R. China. * 2 Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China. * 3 School of Public Health, Xiamen University, Xiamen, P.R. China. * 4 Jurong Health Supervision Institute, Jurong, P.R. China. * 5 Health Team, Mobile Detachment of Shanxi Provincial Corps of the Chinese People's Armed Police Force, Taiyuan, P.R. China. * 6 College of Animal Science and Technology, China Agricultural University, Beijing, P.R. China. * PMID: **42683240** * PMCID: [ PMC13533285 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13533285/) * DOI: [ 10.1515/med-2026-1443 ](https://doi.org/10.1515/med-2026-1443) Item in Clipboard # Global burden of maternal sepsis and other maternal infections from 1990 to 2021, with projections to 2050: risk factors and trends Na Li et al. Open Med (Wars). 2026. Show details Display options Display options Format Abstract PubMed PMID Open Med (Wars) Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Open+Med+%28Wars%29%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Open+Med+%28Wars%29%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42683240/) . 2026 Sep 2;21(1):20261443. doi: 10.1515/med-2026-1443. eCollection 2026 Jan. ### Authors [Na Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+N&cauthor_id=42683240)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-1 "Department of Critical Care Medicine, Xiamen Humanity Hospital, Xiamen, P.R. China."), [Linzi Lei](https://pubmed.ncbi.nlm.nih.gov/?term=Lei+L&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-3 "School of Public Health, Xiamen University, Xiamen, P.R. China.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-4 "Jurong Health Supervision Institute, Jurong, P.R. China."), [Xiyang Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+X&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-3 "School of Public Health, Xiamen University, Xiamen, P.R. China."), [Qingchen Cui](https://pubmed.ncbi.nlm.nih.gov/?term=Cui+Q&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-3 "School of Public Health, Xiamen University, Xiamen, P.R. China."), [Xiaolei Ji](https://pubmed.ncbi.nlm.nih.gov/?term=Ji+X&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-3 "School of Public Health, Xiamen University, Xiamen, P.R. China."), [Shuai Deng](https://pubmed.ncbi.nlm.nih.gov/?term=Deng+S&cauthor_id=42683240)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-5 "Health Team, Mobile Detachment of Shanxi Provincial Corps of the Chinese People's Armed Police Force, Taiyuan, P.R. China."), [Jianhua Yu](https://pubmed.ncbi.nlm.nih.gov/?term=Yu+J&cauthor_id=42683240)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-1 "Department of Critical Care Medicine, Xiamen Humanity Hospital, Xiamen, P.R. China."), [Youzhu Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+Y&cauthor_id=42683240)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-2 "Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42683240/#short-view-affiliation-6 "College of Animal Science and Technology, China Agricultural University, Beijing, P.R. China.") ### Affiliations * 1 Department of Critical Care Medicine, Xiamen Humanity Hospital, Xiamen, P.R. China. * 2 Department of Reproductive Medicine and Reproductive Immunology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, P.R. China. * 3 School of Public Health, Xiamen University, Xiamen, P.R. China. * 4 Jurong Health Supervision Institute, Jurong, P.R. China. * 5 Health Team, Mobile Detachment of Shanxi Provincial Corps of the Chinese People's Armed Police Force, Taiyuan, P.R. China. * 6 College of Animal Science and Technology, China Agricultural University, Beijing, P.R. China. * PMID: **42683240** * PMCID: [ PMC13533285 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13533285/) * DOI: [ 10.1515/med-2026-1443 ](https://doi.org/10.1515/med-2026-1443) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Objectives:** Maternal sepsis and other maternal infections (MSMI) account for approximately 10.7 % of maternal deaths globally with a significant burden persisting in low-income and middle-income countries. **Methods:** Using GBD 2021 data, this ecological analysis extracted incidence, mortality, disability-adjusted life years(DALYs), and their age-standardized rates(ASR) of MSMI globally, across 21 GBD regions, 204 countries and territories from 1990 to 2021. Locally weighted regression and Spearman correlation were used to evaluate associations between MSMI burden and Socio-demographic Index(SDI). Attributable risk burdens were estimated using the GBD comparative risk assessment framework, and the autoregressive integrated moving average(ARIMA) model projected temporal trends. **Results:** In 2021, substantial regional disparities persisted. Low-SDI regions had persistently high burden with slow declines, while high-SDI regions showed low burden converging toward negligible levels. Burden was inversely associated with SDI, peaking in the 20-29 age group. ARIMA projections indicated continued decline in incidence and DALYs, but mortality trends remain uncertain. Maternal malnutrition and iron deficiency were major contributors in low-SDI regions, while behavioral factors played a limited role in high-SDI regions. **Conclusions:** Although global MSMI burden is declining, low-income and low-middle income regions still carry a disproportionately high disease burden. Overall, strengthening early identification, standardized treatment, infection prevention and control, and nutritional interventions remain critical. **Keywords:** ARIMA model; epidemiology; global burden of disease; maternal sepsis and other infections; reproductive health. © 2026 the author(s), published by De Gruyter, Berlin/Boston. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Conflict of interest: All authors state no conflict of interest. ## Similar articles * [ The global, regional, and national burdens of maternal sepsis and other maternal infections and trends from 1990 to 2021 and future trend predictions: results from the Global Burden of Disease study 2021. ](https://pubmed.ncbi.nlm.nih.gov/40087648/) Hu Q, Wang L, Chen Q, Wang Z.Hu Q, et al.BMC Pregnancy Childbirth. 2025 Mar 14;25(1):285. doi: 10.1186/s12884-025-07409-2.BMC Pregnancy Childbirth. 2025.PMID: 40087648Free PMC article. * [ Global, regional and national burden of trachea, bronchus, and lung cancer in middle-aged and elderly people aged 55+ years from 1990 to 2021, with projections to 2036: a systematic analysis of the Global Burden of Disease Study 2021. ](https://pubmed.ncbi.nlm.nih.gov/41522119/) Jin J, Chen Y, Zeng Q, Li M, Zhao J.Jin J, et al.J Thorac Dis. 2025 Dec 31;17(12):11039-11056. doi: 10.21037/jtd-2025-693. Epub 2025 Dec 29.J Thorac Dis. 2025.PMID: 41522119Free PMC article. * [ Disease burden of maternal sepsis and maternal infections in low- and middle-income countries from 1990 to 2023 and projections to 2035: An analysis based on the global burden of disease study. ](https://pubmed.ncbi.nlm.nih.gov/42033897/) Feng B, Duan L, Wang B, Chen B.Feng B, et al.Eur J Obstet Gynecol Reprod Biol. 2026 Jun;322:115145. doi: 10.1016/j.ejogrb.2026.115145. Epub 2026 Apr 22.Eur J Obstet Gynecol Reprod Biol. 2026.PMID: 42033897 * [ Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021. ](https://pubmed.ncbi.nlm.nih.gov/38762325/) GBD 2021 Forecasting Collaborators.GBD 2021 Forecasting Collaborators.Lancet. 2024 May 18;403(10440):2204-2256. doi: 10.1016/S0140-6736(24)00685-8.Lancet. 2024.PMID: 38762325Free PMC article. * [ The epidemiology of pregnancy loss: global burden, variable risk factors, and predictions. ](https://pubmed.ncbi.nlm.nih.gov/38308812/) Tong F, Wang Y, Gao Q, Zhao Y, Zhang X, Li B, Wang X.Tong F, et al.Hum Reprod. 2024 Apr 3;39(4):834-848. doi: 10.1093/humrep/deae008.Hum Reprod. 2024.PMID: 38308812Review. 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