Global, Regional, and National Epidemiology of Postpartum Hemorrhage (1990–2021): A Statistical Analysis of Incidence, Mortality, and DALYs

ABSTRACT Background and Aims Postpartum hemorrhage (PPH) is a leading global cause of maternal mortality and morbidity. This study utilizes global burden of disease (GBD) data to assess its long‐term trends in incidence, mortality, and disability‐adjusted life years (DALYs). Methods Using data from the GBD, we analyzed age‐standardized incidence, mortality, and DALY rates among reproductive‐aged women (15–49 years). Trend analysis was conducted via Joinpoint regression to estimate annual percentage changes (APCs), while future burden projections were modeled using Bayesian age‐period‐cohort (BAPC) analysis. Results From 1990 to 2021, the global age‐standardized incidence rate (ASIR) of PPH declined significantly from 998.26 (95% UI: 654.55–1,438.33) to 722.16 (95% UI: 482.99–1,022.71) per 100,000 population. The estimated annual percentage change (EAPC) was −0.83% (95% UI: −0.90% to −0.77%). Projections suggest this downward trend will continue, with ASIR expected to reach 321.17 (95% UI: 302.55–359.30) by 2035. In 2021, women aged 20–24 years continued to exhibit the highest DALYs, amounting to 749,063 years (95% UI, 629,108.37–894,035.97). From 1990 to 2021, the proportion of DALYs among women of reproductive age attributable to iron deficiency‐related PPH increased from 17.19% (95% UI, 8.65% to 21.48%) to 17.96% (95% UI, 8.67% to 23.95%). Conclusion A sustained decline in the incidence of PPH over the past thirty years—a trend projected to continue through 2035, reflecting the ongoing effectiveness of public health interventions. We also found a potential association with iron deficiency, alongside a consistently higher disease burden observed among women aged 20–24 years.