Trends and inequities in the global burden of maternal mortality, 1990–2023: Findings from the global burden of disease study 2023
Jie YangAbstract
Objectives
This study examines global and regional trends in maternal mortality (1990–2023) and explores shifts in cause‐specific and age‐specific patterns using the latest Global Burden of Disease (GBD) 2023 data.
Methods
We analyzed maternal deaths and age‐standardized mortality rates (ASMR) globally and across Sociodemographic Index (SDI) and GBD regions. Temporal trends were assessed using estimated annual percentage changes (EAPC). Cause‐specific and age‐specific mortality patterns were examined.
Results
Globally, maternal deaths declined by 43.27% from 422 924 in 1990 to 239 929 in 2023, with ASMR falling from 7.46 to 3.00 per 100 000 population. All age‐specific rates declined but with uneven pace. The age distribution shifted toward older women, particularly in high SDI regions where the modal age shifted from 20–24 to 30–34 years. The proportion of hemorrhage decreased, while hypertensive disorders and ectopic pregnancy increased, despite stable or falling absolute rates. ASMR rose in high‐income North America and Southern Sub‐Saharan Africa but fell sharply in East and South Asia. Low SDI regions retained a younger age distribution and high absolute burden despite substantial rate reductions.
Conclusion
Despite global progress, maternal mortality shows uneven epidemiological transition and widening inequities across age, cause, and region. Future strategies must be tailored to local contexts with strengthening emergency obstetric care and early pregnancy diagnostic capacity in low‐resource settings, while integrating multidisciplinary management of complex and indirect causes in higher SDI regions, with a sustained focus on age‐specific and equity‐oriented interventions.