Analyzing Global Trends in Uterine Prolapse Burden: A Comprehensive Study of Incidence and DALYs Across 204 Countries...

Uterine prolapse is a common and debilitating pelvic floor disorder that significantly impairs women's quality of life worldwide. With global population aging and lifestyle transitions, its disease burden has become increasingly pronounced. However, comprehensive analyses of long-term epidemiological trends, driving factors, and health inequalities across different socioeconomic settings remain limited.

This study analyzed data from the Global Burden of Disease (GBD) 2021 study, covering 204 countries and territories from 1990 to 2021. Age-standardized incidence and Disability-Adjusted Life Years (DALYs) rates were calculated. Estimated annual percentage changes (EAPCs) were computed to evaluate temporal trends. Decomposition analysis was performed to quantify the contributions of population growth, population aging, and epidemiological changes to DALY changes. Health inequality was assessed using the Slope Index of Inequality (SII) and Concentration Index (CI) across Socio-demographic Index (SDI) quintiles.

Globally, the age-standardized DALYs rate for uterine prolapse was 9.90 per 100,000 in 2021. Incidence exhibited a bimodal peak at 45-54 years and 90+ years, whereas DALYs increased monotonically with age, peaking in the oldest-old (90+ years). Low and low-middle SDI regions exhibited declining trends, whereas middle, high-middle, and high SDI regions showed increasing trends, with high SDI regions demonstrating a U-shaped resurgence. Decomposition analysis revealed that population growth and aging were the primary drivers of global DALY increases, with epidemiological changes partially offsetting the increase, although this effect varied considerably across SDI levels. Health inequality analysis demonstrated that the burden of uterine prolapse has progressively concentrated among higher SDI populations, with this inequality widening substantially over the past three decades.

The global burden of uterine prolapse has risen over the past three decades, with marked heterogeneity across SDI levels. Interventions should prioritize early screening for midlife women, tiered management for older women, metabolic risk control in high SDI regions, and surgical access in low SDI regions, with resource allocation tailored to national SDI levels and population age structures.