Global Patterns and Temporal Trends in Modifiable Risk Factors Among Women of Childbearing Age, 1990-2021: A Systematic Analysis from the Global Burden of Disease Study.

OBJECTIVE

Women of childbearing age (WCBA, 15-49 years) are a key population for public health prevention, yet evidence on long-term trends in modifiable risk factors and their attributable burden remains limited. We aimed to assess global patterns and temporal changes in major modifiable risk factors among WCBA.

METHODS

Using data from the Global Burden of Disease (GBD) 2021, we analysed summary exposure values, deaths, and disability-adjusted life years (DALYs) attributable to 83 modifiable risk factors across metabolic, behavioural, and environmental/occupational domains.

RESULTS

In 2021, 1.10 million deaths and 108.0 million DALYs among WCBA were attributable to modifiable risk factors, representing 34.83% of total deaths and 26.52% of total DALYs. The leading Level 3 risk factors for DALYs were unsafe sex (4.89%), iron deficiency (3.36%), high body mass index (BMI) (3.19%), and high fasting plasma glucose (FPG) (2.48%). Between 1990 and 2021, environmental and occupational risk exposures generally declined over time, whereas metabolic risk exposures-particularly high BMI (EAPC 1.83%) and high FPG (EAPC 1.59%)-showed sustained increases across most regions. Risk profiles varied across sociodemographic index (SDI) levels, with reproductive and nutritional risks predominating in lower-SDI settings and metabolic or behavioural risks more prominent in higher-SDI settings.

CONCLUSION

Modifiable risk factors account for a substantial proportion of disease burden among WCBA. The coexistence of rising metabolic risks and persistent reproductive and nutritional challenges calls for targeted strategies-strengthening reproductive health and nutrition programmes in lower-SDI settings, and prioritising obesity prevention and metabolic screening in higher-SDI regions.