Global burden of rheumatic heart disease among women of reproductive age: Socioeconomic and temporal trends, 1990 to 2021.

BACKGROUND: Women of reproductive age are an important group to consider in the global burden of rheumatic heart disease (RHD).

AIM: We aimed to systematically analyse the burden of RHD among women of reproductive age from 1990 to 2021.

METHODS: We used Global Burden of Disease (GBD) 2021 to comprehensively analyse the global burden of RHD among women of reproductive age, including incidence, prevalence, mortality and disability-adjusted life years (DALY) and examined the relationship between the burden of disease and different regions, sociodemographic index (SDI) and age.

RESULTS: The incidence and prevalence rates of RHD in women of reproductive age increased globally from 1990 to 2021. The incidence rate (per 100,000 population) increased from 60.37 (95% UI: 44.12-82.42) in 1990 to 64.06 (95% UI: 46.24-86.76) in 2021 and the prevalence rate increased from 951.74 (95% UI: 723.08-1197.48) to 1110.17 (95% UI: 843.45-1402.27). When countries were grouped by SDI, incidence rate and prevalence rate negatively correlated with SDI. Low SDI regions had the highest burden. In 2021, women of reproductive age 15-19years had the most incident cases, and the number of deaths and DALY connected positively with age.

CONCLUSIONS: The increasing incidence of RHD among women of reproductive age represents an important global health concern, particularly in low-SDI regions where the disease burden remains highest. The early onset of RHD highlights the need for preventive efforts targeting younger women. Prevention and management strategies should be adapted to disease patterns and health-system capacity, with an emphasis on early detection and effective secondary prevention in high-burden settings.