Global Burden and Temporal Trends of Idiopathic Epilepsy in Women of Childbearing Age: An Analysis of the Global Burden of Disease Study 1990–2021 and Forecast to 2036

Introduction: As a prevalent chronic neurological condition, idiopathic epilepsy poses particular challenges for women of childbearing age (WCBA) due to distinctive biological and social characteristics. Nevertheless, global evaluations of its burden in this demographic are still limited. Methods: Based on data from the Global Burden of Disease Study 2021, we examined the prevalence, incidence, and disability-adjusted life years (DALYs) associated with idiopathic epilepsy in WCBA from 1990 to 2021, covering global, regional, and national scales. Temporal patterns were evaluated using estimated annual percentage change (EAPC), Joinpoint regression, and age-period-cohort (APC) models. Frontier and decomposition analyses were conducted to examine disparities and driving factors, and associations with sociodemographic index (SDI) were explored. A Bayesian APC model was also employed to forecast the burden through 2036. Results: From 1990 to 2021, the number of WCBA with idiopathic epilepsy increased from 3.54 to 5.38 million, incident cases increased from 0.44 to 0.69 million, and DALYs increased from 2.40 to 3.02 million. Age-standardized prevalence rate (ASPR) remained relatively constant (EAPC = −0.06) with a recent uptick; age-standardized incidence rate (ASIR) experienced a mild increase (EAPC = 0.16); and age-standardized DALYs (ASR-DALYs) declined (EAPC = −0.59). High-SDI areas exhibited relatively stable burden, while low- and middle-SDI regions experienced marked increases. Frontier analysis revealed a substantial gap between actual and achievable burden levels in many countries. Population growth was the main contributor to the rising burden, whereas high-SDI countries benefited more from epidemiological advances. Projections estimate that by 2036, the number of WCBA with epilepsy will reach approximately 7.13 million, with upward trends in ASPR, ASIR, and ASR-DALYs. The APC model indicated highest epilepsy risk during adolescence and divergent burden trends across SDI regions. Conclusion: Despite favorable trends in ASR-DALYs, idiopathic epilepsy still exerts a rising burden on WCBA, with significant variation across regions. There is an urgent need for region-specific and population-focused prevention strategies.