Global, regional and national burden of osteoarthritis in women of childbearing age from 1990 to 2021, with projected trends up to 2045

PURPOSE: This study aims to systematically quantify the global burden of osteoarthritis (OA) in women of childbearing age (WCBA) and analyze its temporal trends and regional disparities. METHODS: This study utilized the Global Burden of Disease 2021 data to assess the incidence and years lived with disability (YLDs) spanning from 1990 to 2021. The Bayesian age-period-cohort (BAPC) model was adopted to forecast trends up to 2045. An analysis was conducted on the disparities across various age subgroups and regions with different socio-demographic index (SDI) levels. RESULTS: In 2021, the global incidence of OA among WCBA stood at 8,222,896 cases. Age-standardized rates for both incidence and YLDs were most elevated in the High-income Asia Pacific, East Asia and High-income North America. That year, the global OA burden within this demographic was predominantly driven by knee and hand OA, with hand OA notably surpassing hip OA to rank second only to knee OA. In Eastern Europe and Central Asia, hand OA even overtook knee OA as the most prevalent type of OA. From 1990 to 2021, hand OA demonstrated the most rapid incidence growth with an estimated annual percentage change of 0.79 (95% confidence intervals: 0.72-0.86), with particularly marked surges in East Asia, High-income Asia Pacific and Southeast Asia. The 45-49 age bracket carried the greatest burden across all types of OA. Projections through 2045 suggest that cases of hand and hip OA will undergo substantial growth, whereas knee OA cases will increase more moderately. Despite a potential minor downturn in its age-standardized incidence and YLD rate, knee OA is poised to remain the primary culprit. Throughout the analysis, striking regional and socioeconomic disparities in the OA burden were readily apparent. CONCLUSION: This study reveals a growing global burden of OA among WCBA, driven primarily by knee and hand OA. These findings underscore the need to integrate WCBA into OA prevention strategies and musculoskeletal health policies tailored to age, region and joint type. LEVEL OF EVIDENCE: N/A.