Global, regional, and national ectopic pregnancy burden: A trend analysis of global disease burden from 1990 to 2021

Ectopic pregnancy is a serious gynecological emergency that imposes a significant global burden. This research aims to provide an effective reference for future strategic planning in various countries. Ectopic pregnancy data from 1990 to 2021 were analyzed, the autoregressive integrated moving average (ARIMA) and exponential smoothing (ES) models were used to predict future disease burden. Compared with 1990, the number of deaths and disability-adjusted life years (DALYs) increased, while the incidence number decreased notably. The age‑standardized incidence rate (ASIR) decreased by 46.12 per 100,000 (estimated annual percentage change (EAPC): -0.91, 95 percent CI: -1.02 to -0.8). The age‑standardized mortality rate (ASMR) remained stable (EAPC: 0.01, 95 percent CI: -0.07-0.08), and the age‑standardized DALY rate (ASDR) decreased slightly (EAPC: 0.05, 95 percent CI: -0.03-0.13). Prevalence also declined (ASPR EAPC: -0.91, 95 percent CI: -1.02 to -0.8), though incidence remains the primary focus for this acute condition. Across all indicators, the burden of ectopic pregnancy was concentrated within the age group of 10-54 years and predominantly in the 20-29 age group. Disease burden in low sociodemographic index (SDI) regions was higher than in other SDI regions. The regions and countries with the highest disease burden were located mainly in Africa. Although some global indicators have decreased over the past 30 years, the burden in low SDI regions has remained high. Enhancing cross-national collaboration may help reduce the disease burden in high-burden nations and areas.