Epidemiological trends in abortion and miscarriage between 1990 and 2019

BACKGROUND: Abortion and miscarriage both lead to pregnancy loss, with miscarriage occurring spontaneously and abortion referring to the intentional ending of pregnancy. In this context, unsafe remains a major threat to reproductive health. To inform public health strategies and improve maternal health outcomes, it is essential to monitor the epidemiological data associated with abortion and miscarriage. In this study, we utilized data from the Global Burden of Disease Study (GBD) 2019 to comprehensively assess the global burden of abortion and miscarriage from 1990 to 2019. METHODS: The available data were stratified by year, age, and social development index (SDI) at the global, regional, and country levels from the GBD 2019 database. Furthermore, we employed estimated annual percentage changes (EAPCs) to assess the age-standardized rates of abortion and miscarriage. Additionally, linear regression analysis was conducted to examine the relationship between abortion rates and SDI values. RESULTS: The global incidence of abortion and miscarriage decreased from 49,637,961 in 1990 to 42,385,827 in 2019. The number of deaths dropped significantly from 59,475 to 19,565, while disability-adjusted life years (DALYs) decreased from 3,449,222 to 1,130,038 over the same period. Despite this overall decline, the disease burden remains substantial in some regions. The low-SDI had the highest age-standardized incidence rate (ASIR), reaching 1,983.8 per 100,000. At the national level, Ethiopia recorded the highest ASIR at 3,839.06 per 100,000 in 2019, followed by Bolivia at 3,524.9 per 100,000. Among 204 countries and territories, Chad (17.59 per 100,000) and Niger (14.02 per 100,000) had the highest age-standardized death rates (ASDR) in 2019. Among the 21 GBD regions, Eastern Sub-Saharan Africa had the highest DALY rate in 2019, amounting to 208.42 per 100,000. Globally, a high incidence cases (13,341,611) was recorded for young women aged 20 to 29 years, meanwhile deaths (3,239) was higher in women aged 35 to 44 years. CONCLUSIONS: By identifying key risk factors and high-burden areas, we hope to provide a usable theoretical basis for policymakers and healthcare professionals to develop targeted interventions that improve reproductive health outcomes.