Maternal hemorrhage among women aged 15-49: declining incidence but increasing global gaps

To analyse global temporal trends in the incidence of maternal haemorrhage among women of reproductive age, and to assess associations with the sociodemographic index (SDI).

Data were obtained from international health databases, including the Global Burden of Disease Study, to extract the number of maternal haemorrhage cases and incidence rates for women aged 15-49 years by country/territory, age group and SDI region over the period 1990-2021. Temporal changes in incidence were quantified using the estimated annual percentage change (EAPC). Correlations between incidence and SDI were analysed.

Globally, maternal haemorrhage cases declined slightly from 14.1 million in 1990 to 13.9 million in 2021 (EAPC = -1.03). The incidence rate decreased from 1,056.09 to 714.00 per 100,000 women. Marked declines were noted in age groups 15-19 years (EAPC = -1.48), 20-24 years (EAPC = -1.39) and 45-49 years (EAPC = -2.46). The steepest reductions occurred in low-middle SDI regions (EAPC = -2.13), while some high-SDI regions (e.g., Eastern Europe) experienced modest increases. Sub-Saharan Africa remained the region with the highest incidence (>1,000 per 100,000). A significant negative correlation was observed between SDI and maternal haemorrhage incidence.

Although global incidence of maternal haemorrhage in women of reproductive age has declined over the past three decades, substantial regional and sociodemographic disparities persist. The findings highlight that improvements in obstetric and public health systems have had global impact, yet targeted efforts are needed in low-SDI regions to achieve maternal health equity.