Spatial analysis of risk areas of congenital anomalies in Brazil, 2012-2021

Souza, Suzana de; Carvalho, Clarissa Gutierrez; Schuler-Faccini, Lavinia

doi:10.1590/S2237-96222025v34e20250240.en

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 34 • 2025 • https://doi.org/10.1590/S2237-96222025v34e20250240.en linkcopy

Spatial analysis of risk areas of congenital anomalies in Brazil, 2012-2021

Análisis espacial de áreas de riesgo de anomalías congénitas en Brasil, 2012-2021

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To identify areas at risk for congenital anomalies in Brazil, from 2012 to 2021.

Method Time series analysis using data from the Live Birth Information System. Prevalence of anomalies in the period was calculated according to immediate geographic region. Spatial analysis was performed by calculating the Global and Local Moran index and spatial scanning, with calculation of Relative Risk (RR) and p-value, for the risk areas.

Results Areas at higher risk for anomalies were identified in the Northeast, Southeast, and Southern regions. The Northeast region had a higher number of clusters (n=31) and higher prevalence of nervous system anomalies compared to the other regions (9.7/10,000 live births). The highest risk of anomalies compared to the other areas was found in the state of Paraíba (RR 2.4; p-value<0.001).

Conclusion Disparities in the distribution of congenital anomalies were identified in Brazil, with risk areas in the Northeast, Southeast, and Southern regions.

Keywords
Congenital Abnormalities; Risk; Newborn; Spatial Analysis; Environment and Public Health

Anomaly	Prevalence per 10,000 live births (%)
Anomaly	North	Northeast	Southeast	South	Midwest	Brazil
Spina bífida	1.5 (2.7)	2.2 (2.8)	2.6 (2.6)	2.4 (2.9)	1.7 (2.5)	2.2 (2.7)
Other congenital malformations of the nervous system	7.3 (12.7)	9.7 (12.4)	8.1 (8.2)	6.2 (7.6)	6.7 (10)	8.1 (9.7)
Congenital malfor-mations of the circu-latory system	2.5 (4.3)	3.3 (4.3)	15.2 (15.4)	9.6 (11.6)	3.8 (5.7)	8.8 (10.5)
Cleft lip and cleft palate	4.9 (8.4)	4.6 (5.9)	5.4 (5.5)	6.8 (8.2)	5.1 (7.6)	5.3 (6.3)
Absence, atresia and stenosis of the small intestine	0.1 (0.2)	0.1 (0.1)	0.3 (0.3)	0.3 (0.3)	0.1 (0.1)	0.2 (0.2)
Other congenital malformations do digestive system	5.1 (8.8)	2.9 (3.7)	4.8 (4.9)	3.5 (4.2)	2.8 (4.2)	4 (4.8)
Undescended testicle	0.5 (0.9)	1.4 (1.8)	2 (2)	1.3 (1.6)	1 (1.5)	1.5 (1.8)
Other malformations of the genitourinary system	2.9 (5)	6.8 (8.7)	7.4 (7.5)	6.9 (8.4)	5 (7.5)	6.5 (7.7)
Congenital deformi-ties of the hip	0.2 (0.3)	0.3 (0.4)	1 (1)	0.3 (0.4)	0.4 (0.6)	0.6 (0.7)
Congenital deformi-ties of the feet	8 (13.9)	10.3 (13.2)	9 (9.1)	9.4 (11.4)	8.8 (13.1)	9.3 (11.1)
Other congenital malformations and deformations of the musculoskeletal system	14.7 (25.5)	22.5 (28.8)	25 (25)	19.9 (24.1)	20.1 (30)	22.1 (26.4)
Other congenital malformations	7.5 (12.9)	10.8 (13.9)	12.9 (13.1)	10.4 (12.6)	9 (13.4)	11.1 (13.3)
Chromosomal ab-normalities not else-where classified	2.2 (3.9)	2.9 (3.7)	4.2 (4.3)	5.1 (6.2)	2.4 (3.7)	3.6 (4.3)
Hemangioma and lymphangioma	0.2 (0.3)	0.2 (0.3)	0.5 (0.5)	0.5 (0.6)	0.2 (0.4)	0.3 (0.4)
Total	57.7 (100)	78.1 (100)	98.4 (100)	82.5 (100)	67.1 (100)	83.6 (100)

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