Canadian trends in maternal disorders, 1990-2017: Findings from the Global Burden of Disease Study 2017

Introduction: Worldwide, preventable deaths during pregnancy and childbirth affect around 300,000 women, annually. In Canada, there are restricted methods for surveillance of maternal health. In this regard, the Global Burden of Disease (GBD) Study represents an alternative tool to evaluate trends in maternal disorders. Our objective is to investigate GBD trends in Canadian maternal disorders, and to compare these to the international context.

Methods: We used GBD 2017 Study estimates from 1990 to 2017. Prevalence, incidence, and deaths from maternal disorders were extracted from the GBD compare tool (https://vizhub.healthdata.org/gbd-compare/). Disease Modeling Bayesian Meta-Regression II was used to estimate prevalence and incidence of GBD modeled non-fatal maternal diseases. Cause of death Ensemble modelling was used to estimate maternal mortality. The 95% uncertainty intervals (UI) were calculated for each estimate.

Results: Maternal mortality has remained steady since 1990 at roughly 0.1 deaths per 100,000 women per year, 43 times lower than global rates. Globally, the prevalence and incidence of maternal disorders decreased by roughly 25% from 1990 to 2017. In Canada, the prevalence decreased until 2010, and then slighted increased after 2011 to 52.4 (95%UI: 39.8-67.6) prevalent cases per 100,000 women in 2017. The incidence also increased in the last 10 years to a rate of 403.2 (95% UI: 346.2-467.1) new cases per 100,000 in 2017. The two most prevalent maternal disorders over the period were maternal sepsis and maternal hypertension.

Conclusion: The findings of this study suggest that although estimated rates of maternal disorders in Canada were lower compared to global estimates, they have increased in more recent years. Our results should be interpreted with caution since the modeled GBD estimates may not align with national surveillance estimates, and Canadian regional (province and territory) data are not currently available for the GBD Study.