Global and China burden of ectopic pregnancy (1990–2021): Trends, patterns, and future projections

OBJECTIVE: This study evaluated the burden of ectopic pregnancy (EP) in China and globally from 1990 to 2021, aiming to enhance public awareness of EP and provide a scientific basis for formulating prevention and control strategies. METHODS: Data on incidence, prevalence, deaths, and disability-adjusted life years (DALYs) were obtained from the Global Burden of Disease 2021. This systematic review evaluates temporal variations in EP, demographic disparities in exposure, and associated risk determinants. The Bayesian Age-Period-Cohort and Nordpred models were used to predict future trends. RESULTS: Overall, the burden of EP in China and globally has decreased over the past 32 years. However, it is worth noting that the global numbers of DALYs and deaths increased by 37.76% and 38.96%, respectively. From an age perspective, the peak burden age group has shifted slightly older, but women aged 20-24 worldwide still face higher risks of disability and mortality. Iron deficiency is the only risk factor for EP that has been quantified and included in the burden attribution calculations. Predictions show that the future burden may further decline, but both age standardization rates of DALYs and deaths may still increase. CONCLUSION: Although the burden of EP in China and globally has decreased from 1990 to 2021, the situation remains severe. Future public health policies should not only allocate resources based on the socio-demographic index, but also address the nutrition-related risk factors in reproductive health and formulate more targeted prevention and control strategies.