Ke Tang,* Jiayao Feng,* Hongshen Lai, Zhongxiang Zhao, Yeson Zou, Qian Lv, Fazhong Dai, Xiaofu Qiu, Wenjie Lai

Department of Urology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, Guangdong, 510317, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wenjie Lai; Xiaofu Qiu, Department of Urology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, Guangdong, 510317, People’s Republic of China, Tel +86-020-89168269, Email laiwj@gd2h.org.cn; qiuxf@gd2h.org.cn

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.

Keywords: urinary tract infection (UTI), premenopausal women, postmenopausal women, disease burden, global trends