{
    "abstract": "Obstructed labor (OL) and uterine rupture (UR) are common obstetric complications. This study explored the burden, risk factors, decomposition, and health inequalities associated with OL and UR to improve global maternal health.\nThis was a cross-sectional analysis study including data on OL and UR from the Global Burden of Diseases, and Risk Factors Study (GBD) 2019. The main outcome measures included the number and age-standardized rate (ASR) of incidence, disability-adjusted life years (DALYs), prevalence, and deaths.\nThe global burden of OL and UR has declined, with a decrease in incidence (number in 2019: 9,410,500.87, 95%UI 11,730,030.94 to 7,564,568.91; ASR in 2019: 119.64 per 100,000, 95%UI 149.15 to 96.21; estimated annual percentage change [EAPC] from 1990 to 2019: -1.34, 95% CI -1.41 to -1.27) and prevalence over time. However, DALYs (number in 2019: 999,540.67, 95%UI 1,209,749.35 to 817,352.49; ASR in 2019: 12.92, 95%UI 15.63 to 10.56; EAPC from 1990 to 2019: -0.91, 95% CI -1.26 to -0.57) and deaths remain significant. ASR of DALYs increased for the 10-14 year-old age group (2.01, 95% CI 1.53 to 2.5), the 15-19 year-old age group (0.07, 95% CI -0.47 to 0.61), Andean Latin America (3.47, 95% CI 3.05 to 3.89), and Caribbean (4.16, 95% CI 6 to 4.76). Iron deficiency was identified as a risk factor for OL and UR, and its impact varied across different socio-demographic indices (SDIs). Decomposition analysis showed that population growth primarily contributed to the burden, especially in low SDI regions. Health inequalities were evident, the slope and intercept for DALYs were -\u200947.95 (95% CI -52.87 to -43.02) and -\u200929.29 (95% CI -32.95 to -25.63) in 1990, 39.37 (95%CI 36.29 to 42.45) and 24.87 (95%CI 22.56 to 27.18) in 2019. Concentration indices of ASR-DALYs were -\u20090.2908 in 1990 and -\u20090.2922 in 2019.\nThis study highlights the significant burden of OL and UR and emphasizes the need for continuous efforts to reduce maternal mortality and morbidity. Understanding risk factors and addressing health inequalities are crucial for the development of effective interventions and policies to improve maternal health outcomes globally.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Gulou District, Fuzhou, 350001, China.\nFujian Clinical Research Center for Maternal-Fetal Medicine, Fuzhou, China.\nNational Key Obstetric Clinical Specialty Construction Institution of China, Fuzhou, China.",
            "firstname": "Mingxing",
            "initials": "M",
            "lastname": "Yan"
        },
        {
            "affiliation": "Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, 420 Fuma Road, Jin'an District, Fuzhou, 350014, Fujian, China. hui_li@fjmu.edu.cn.",
            "firstname": "Hui",
            "initials": "H",
            "lastname": "Li"
        },
        {
            "affiliation": "Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Gulou District, Fuzhou, 350001, China.\nFujian Clinical Research Center for Maternal-Fetal Medicine, Fuzhou, China.\nNational Key Obstetric Clinical Specialty Construction Institution of China, Fuzhou, China.",
            "firstname": "Xinye",
            "initials": "X",
            "lastname": "Zheng"
        },
        {
            "affiliation": "Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Gulou District, Fuzhou, 350001, China.\nFujian Clinical Research Center for Maternal-Fetal Medicine, Fuzhou, China.\nNational Key Obstetric Clinical Specialty Construction Institution of China, Fuzhou, China.",
            "firstname": "Feng",
            "initials": "F",
            "lastname": "Li"
        },
        {
            "affiliation": "Department of Obstetrics and gynecology, Ningde Hospital Affiliated to Ningde Normal University, Ningde, China.",
            "firstname": "Chen",
            "initials": "C",
            "lastname": "Gao"
        },
        {
            "affiliation": "Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Gulou District, Fuzhou, 350001, China. liying_li@fjmu.edu.cn.\nFujian Clinical Research Center for Maternal-Fetal Medicine, Fuzhou, China. liying_li@fjmu.edu.cn.\nNational Key Obstetric Clinical Specialty Construction Institution of China, Fuzhou, China. liying_li@fjmu.edu.cn.",
            "firstname": "Liying",
            "initials": "L",
            "lastname": "Li"
        }
    ],
    "conclusions": "This study highlights the significant burden of OL and UR and emphasizes the need for continuous efforts to reduce maternal mortality and morbidity. Understanding risk factors and addressing health inequalities are crucial for the development of effective interventions and policies to improve maternal health outcomes globally.",
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1186/s12889-024-19429-2\n10.1111/1471-0528.16880\n10.1001/jama.2017.8390\n10.1093/bmb/ldg018\n10.1111/1471-0528.16363\n10.1503/cmaj.071750\n10.1097/AOG.0000000000002373\n10.1016/S0140-6736(16)31395-2\n10.1016/j.ajog.2020.12.006\n10.1016/S2214-109X(23)00468-0\n10.1089/jwh.2020.8855\n10.1161/CIR.0000000000001000\n10.1186/s12992-015-0117-9\n10.1016/j.ajog.2022.04.035\n10.1186/s12884-017-1558-3\n10.7326/M19-3258\n10.1001/jama.2023.21294\n10.1111/1468-0009.12442\n10.1111/1471-0528.14040\n10.1016/j.ajog.2017.07.025\n10.1016/j.socscimed.2022.115043\n10.1016/j.bpobgyn.2019.01.009\n10.1186/s12992-016-0189-1\n10.1016/S0140-6736(16)31533-1\n10.7326/M19-3259\n10.1186/s12939-017-0558-2",
    "journal": "BMC public health",
    "keywords": [
        "Global burden",
        "Health inequality",
        "Maternal obstructed labor",
        "Uterine rupture"
    ],
    "methods": null,
    "publication_date": "2024-07-30",
    "pubmed_id": "39075414\n34455672\n28742896\n14711764\n32534459\n18195282\n29215521\n37773990\n27642020\n33309560\n38070536\n33211615\n34548643\n34493059\n26276053\n35487324\n29132349\n33253021\n37831443\n31943403\n27126671\n28743440\n35660699\n30837118\n27600397\n27642022\n33253019\n28427423",
    "results": "The global burden of OL and UR has declined, with a decrease in incidence (number in 2019: 9,410,500.87, 95%UI 11,730,030.94 to 7,564,568.91; ASR in 2019: 119.64 per 100,000, 95%UI 149.15 to 96.21; estimated annual percentage change [EAPC] from 1990 to 2019: -1.34, 95% CI -1.41 to -1.27) and prevalence over time. However, DALYs (number in 2019: 999,540.67, 95%UI 1,209,749.35 to 817,352.49; ASR in 2019: 12.92, 95%UI 15.63 to 10.56; EAPC from 1990 to 2019: -0.91, 95% CI -1.26 to -0.57) and deaths remain significant. ASR of DALYs increased for the 10-14 year-old age group (2.01, 95% CI 1.53 to 2.5), the 15-19 year-old age group (0.07, 95% CI -0.47 to 0.61), Andean Latin America (3.47, 95% CI 3.05 to 3.89), and Caribbean (4.16, 95% CI 6 to 4.76). Iron deficiency was identified as a risk factor for OL and UR, and its impact varied across different socio-demographic indices (SDIs). Decomposition analysis showed that population growth primarily contributed to the burden, especially in low SDI regions. Health inequalities were evident, the slope and intercept for DALYs were -\u200947.95 (95% CI -52.87 to -43.02) and -\u200929.29 (95% CI -32.95 to -25.63) in 1990, 39.37 (95%CI 36.29 to 42.45) and 24.87 (95%CI 22.56 to 27.18) in 2019. Concentration indices of ASR-DALYs were -\u20090.2908 in 1990 and -\u20090.2922 in 2019.",
    "title": "The global burden, risk and inequality of maternal obstructed labor and uterine rupture from 1990 to 2019.",
    "xml": "<Element 'PubmedArticle' at 0x788502b4d170>"
}