Global Burden and Trends of UTI in Premenopausal and Postmenopausal Women from 1990 to 2021 and Projections to 2044.

Objective: Urinary tract infection (UTI) are an important health issue for women, and this study aimed to assess the different disease burdens in premenopausal and postmenopausal women. Methods: In this cross-sectional study, secondary analysis was conducted using Global Burden of Disease (GBD) 2021 data to assess the burden of urinary tract infections in women. Our study applied a joinpoint regression model to assess temporal trends and factors, an age-period-cohort (APC) analysis to evaluate age, period, and cohort effects, and a health inequality analysis to examine regional disparities based on the socio-demographic index (SDI), along with a predictive model for future trend forecasting. Results: From 1990 to 2021, UTI incidence grew faster in premenopausal women (average annual percentage change [AAPC] 0.17 [95% CI 0.15-0.18]) than in postmenopausal women (AAPC 0.04 [95% CI 0.02-0.07]), while mortality increased more for postmenopausal women (AAPC 1.08 [95% CI 0.81-1.36]) than premenopausal women (AAPC 0.45 [95% CI 0.33-0.56]). The COVID-19 pandemic saw a surge in premenopausal UTI incidence (AAPC 0.64 [95% CI 0.62-0.66]). Age, period, and cohort analyses revealed an age-related risk increase in premenopausal women, especially in early birth cohorts. Global health inequalities escalated, with a heavier UTI burden in lower SDI countries. By 2044, projections predict 253.33 million cases in premenopausal and 164.72 million in postmenopausal women, with the biggest increases in the 30-34 and 50-54 age brackets. Conclusion: The study underscores global UTI burden disparities between pre- and postmenopausal women, worsened by COVID-19, urging future policies to enhance healthcare access, antibiotic stewardship, and high-risk group targeting.