BMC infectious diseases · 2026
Distribution and trends of the global burden of female infertility attributable to sexually transmitted infections from 1990 to 2021.
СтатьяНазвание и аннотация: Перевод в очереди
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Li Tianyu, Long Siyu, Ye Zhishan, Tang Zhichen, Song Yaping, Su Min, Zhou Bin, Wang Yanyun, Zhang Lin
Аннотация
BACKGROUND: Sexually transmitted infections (STIs) contribute to female infertility by causing pelvic inflammatory disease (PID) and fallopian tube damage. Utilizing the Global Burden of Disease (GBD) database, we aim to comprehensively evaluate the global disease burden and spatiotemporal trends of STIs-related infertility, which is critical for formulating targeted intervention strategies.
METHODS: Using data from the GBD 2021 database, we extracted age-standardized prevalence rates (ASPR) and age-specific prevalences (in 5-year intervals from 15 to 49 years) for STIs-related primary infertility (SRPI) and secondary infertility (SRSI) across global, socio-demographic index (SDI) regions, and GBD regions from 1990 to 2021. The analysis of spatiotemporal trends involved calculating estimated annual percentage changes (EAPC) and developing age-period-cohort (A-P-C) models.
RESULTS: From 1990 to 2021, global ASPR of SRPI and SRSI remained stable, with EAPCs of -0.18 (95% CI: -0.28 to -0.08) and 0.01 (95% CI: -0.04 to 0.07), respectively. Low SDI regions showed significant burden reduction, while high SDI regions exhibited rising trends. Pathogen-specific trends varied markedly: gonorrhoea-related infertility declined globally (SRPI EAPC = -0.95; SRSI EAPC = -0.61), whereas chlamydia-related SRSI increased slightly (EAPC = 0.10). Age-stratified analysis revealed rising SRPI burden in the 40-49 age group and increasing SRSI in the 15-34 age group. SDI and disease burden showed dynamic correlations: negative at low SDI (< 0.4) but positive at high SDI (> 0.7). The APC model further indicated age effects peak for SRPI and SRSI at 40-44 and 40-45 years, respectively, with declining period effects in high-SDI regions.
CONCLUSIONS: The global burden of STIs-related infertility exhibits regional and age-specific heterogeneity. While low-SDI regions achieved notable progress, rising burdens in high-SDI areas demand urgent attention. Future strategies should integrate pathogen-specific interventions, age-targeted management, and SDI-driven resource allocation to enhance early screening, treatment, and global reproductive health equity.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: Using data from the GBD 2021 database, we extracted age-standardized prevalence rates (ASPR) and age-specific prevalences (in 5-year intervals from 15 to 49 years) for STIs-related primary infertility (SRPI) and secondary infertility (SRSI) across global, socio-demographic index (SDI) regions, and GBD regions from 1990 to 2021. The analysis of spatiotemporal trends involved calculating estimated annual percentage changes (EAPC) and developing age-period-cohort (A-P-C) models.
RESULTS: From 1990 to 2021, global ASPR of SRPI and SRSI remained stable, with EAPCs of -0.18 (95% CI: -0.28 to -0.08) and 0.01 (95% CI: -0.04 to 0.07), respectively. Low SDI regions showed significant burden reduction, while high SDI regions exhibited rising trends. Pathogen-specific trends varied markedly: gonorrhoea-related infertility declined globally (SRPI EAPC = -0.95; SRSI EAPC = -0.61), whereas chlamydia-related SRSI increased slightly (EAPC = 0.10). Age-stratified analysis revealed rising SRPI burden in the 40-49 age group and increasing SRSI in the 15-34 age group. SDI and disease burden showed dynamic correlations: negative at low SDI (< 0.4) but positive at high SDI (> 0.7). The APC model further indicated age effects peak for SRPI and SRSI at 40-44 and 40-45 years, respectively, with declining period effects in high-SDI regions.
CONCLUSIONS: The global burden of STIs-related infertility exhibits regional and age-specific heterogeneity. While low-SDI regions achieved notable progress, rising burdens in high-SDI areas demand urgent attention. Future strategies should integrate pathogen-specific interventions, age-targeted management, and SDI-driven resource allocation to enhance early screening, treatment, and global reproductive health equity.
CLINICAL TRIAL NUMBER: Not applicable.