{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T14:03:26Z","timestamp":1782137006191,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examines global and regional trends in maternal mortality (1990\u20132023) and explores shifts in cause\u2010specific and age\u2010specific patterns using the latest Global Burden of Disease (GBD) 2023 data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed maternal deaths and age\u2010standardized mortality rates (ASMR) globally and across Sociodemographic Index (SDI) and GBD regions. Temporal trends were assessed using estimated annual percentage changes (EAPC). Cause\u2010specific and age\u2010specific mortality patterns were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Globally, maternal deaths declined by 43.27% from 422\u2009924 in 1990 to 239\u2009929 in 2023, with ASMR falling from 7.46 to 3.00 per 100\u2009000 population. All age\u2010specific rates declined but with uneven pace. The age distribution shifted toward older women, particularly in high SDI regions where the modal age shifted from 20\u201324 to 30\u201334\u2009years. The proportion of hemorrhage decreased, while hypertensive disorders and ectopic pregnancy increased, despite stable or falling absolute rates. ASMR rose in high\u2010income North America and Southern Sub\u2010Saharan Africa but fell sharply in East and South Asia. Low SDI regions retained a younger age distribution and high absolute burden despite substantial rate reductions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite global progress, maternal mortality shows uneven epidemiological transition and widening inequities across age, cause, and region. Future strategies must be tailored to local contexts with strengthening emergency obstetric care and early pregnancy diagnostic capacity in low\u2010resource settings, while integrating multidisciplinary management of complex and indirect causes in higher SDI regions, with a sustained focus on age\u2010specific and equity\u2010oriented interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71143","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T13:31:12Z","timestamp":1782135072000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends and inequities in the global burden of maternal mortality, 1990\u20132023: Findings from the global burden of disease study 2023"],"prefix":"10.1002","author":[{"given":"Jie","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Basic Teaching Qingdao Open University  Qingdao Shandong Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Nations U.Millennium Development Goals.https:\/\/www.un.org\/millenniumgoals\/"},{"key":"e_1_2_9_3_1","unstructured":"Organization WH.Topics: SDG target 3.1 maternal mortality.https:\/\/www.who.int\/data\/gho\/data\/themes\/topics\/sdg\u2010target\u20103\u20101\u2010maternal\u2010mortality"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.ogc.2022.07.001","article-title":"Maternal mortality in low and middle\u2010income countries","volume":"49","author":"Lawrence ER","year":"2022","journal-title":"Obstet Gynecol Clin N Am"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-025-23814-w","article-title":"Global, regional, and national burden of maternal disorders, 1990\u20102021: a systematic analysis from the global burden of disease study 2021","volume":"25","author":"Huang J","year":"2025","journal-title":"BMC Public Health"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-025-23738-5","article-title":"Global, regional, and national trends in maternal hemorrhage, 1992\u20102021: a hierarchical cluster and age\u2010period\u2010cohort analysis of the global burden of disease study 2021 and projections to 2036","volume":"25","author":"Fang P","year":"2025","journal-title":"BMC Public Health"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-025-07766-y","article-title":"Global burden of maternal hypertensive disorders (1990\u20102045): trends, regional disparities, and causal links to occupational exposures","volume":"25","author":"Xiong J","year":"2025","journal-title":"BMC Pregnancy Childbirth"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2024.1428271","article-title":"Trends and predictions of maternal sepsis and other maternal infections among women of childbearing age: a systematic analysis for the global burden of disease study 2019","volume":"12","author":"Qian H","year":"2024","journal-title":"Front Public Health"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-025-24228-4","article-title":"Maternal disorders among women aged 15 to 49\u2009years: global trends and inequalities from the GBD study 2021","volume":"25","author":"Mai T","year":"2025","journal-title":"BMC Public Health"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/S0140-6736(25)01917-8","article-title":"Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990\u20102023: a systematic analysis for the global burden of disease study 2023","volume":"406","year":"2025","journal-title":"Lancet"},{"key":"e_1_2_9_11_1","volume-title":"Global Burden of Disease Study 2023 (GBD 2023) Causes of Death and Nonfatal Causes Mapped to ICD Codes","author":"Network. 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