trends in maternal mortality, incidence and daly rates associated with abortion and miscarriage across sdi levels: insights from the gbd 2021 dataset

Background: abortion is considered a major public health issue, especially in low- and middle-income countries. there is a lack of recent global trend analyses stratified by sociodemographic index (sdi) that comprehensively assess maternal mortality, incidence, and disability-adjusted life years.objective: this study examines global disparities in maternal mortality, incidence, and disability-adjusted life years (dalys) related to abortion and miscarriage.methods:this secondary data analysis utilized the global burden of disease (gbd) 2021 dataset to extract maternal mortality ratios (mmrs), incidence rates, and disability‑adjusted life years (dalys) related to abortion and miscarriage from 1990 to 2021, all reported with 95% uncertainty intervals (uis). analyses were conducted using age‑standardized rates and among women aged 15–49 years, stratified by socio‑demographic index (sdi) categories. temporal trends in age‑standardized rates were assessed using joinpoint regression software (version 4.8.0.1).results: over the 31‑year period, joinpoint trend analysis showed a significant global decline in all indicators. daly rates decreased from 104.39 to 25.73, maternal mortality ratios declined from 36.07 to 12.92, and incidence rates decreased from 1603.84 to 1001.64 per 100,000 population. high‑ and high‑middle‑sdi countries experienced the steepest and most significant declines, whereas low‑sdi countries showed the smallest reductions and continued to bear the highest burden in 2021.conclusion: maternal mortality, incidence, and daly rates related to abortion and miscarriage have substantially declined worldwide. while high and high-middle sdi countries experienced the steepest declines, substantial inequalities persist, with low-sdi countries continuing to bear a disproportionately high burden in 2021. these persistent disparities highlight the need for continued action.