Anomalias Congênitas Em Parnaíba-Pi: Uma Análise Epidemiológica, Retrospectiva E De Fatores Associados Em Neonatos

Abstract

Introduction: Congenital anomalies (CA) are functional, structural, or metabolic alterations that occur during intrauterine life and are identified during prenatal care or after the birth of the newborn (NB). Their etiology encompasses genetic, environmental, multifactorial, or unknown events. Factors such as maternal age, nutrition, drug abuse, acquired and genetic disorders can influence the prevalence of CA. In Brazil, data on the occurrence of CA are obtained from Live Birth Certificates (Declaração de Nascido Vivo - DNV) and stored in the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos - Sinasc). Objectives: To analyze the birth prevalence of congenital anomalies in Parnaíba-PI between 2018 and 2023, characterizing them, associating cases with related factors, and conducting a retrospective investigation. Methodology: This is a cross-sectional epidemiological study approved by the Research Ethics Committee of UFDPar under protocol 6.483.843. Data collection was conducted through Sinasc using DNV, obtained from the Parnaíba-PI Health Department. Variables associated with the NB and pregnant women were analyzed within the sociodemographic and obstetric context. A case-control analysis was performed using the variables as exposure factors to calculate the Odds Ratio (OR) with a 95% confidence interval (CI) and significance level of p<0.05 using the BioEstat 5.3 software. Results: Among the 14,109 DNV, 92 presented some type of CA, with a birth prevalence of 65 per 10,000 live births. Regarding variables among NBs with CA, the sex distribution was 51.09% male, 31.52% had a birth weight <2500g, the Apgar score was <7 in 28.26% at 1 minute and 10.87% at 5 minutes, and gestational age was preterm in 29.35%. The history of abortions and other individual information was absent in the DNV. The highest frequencies of CA were in the musculoskeletal system (49.56%) and cleft lip/palate (9.73%). In the retrospective analysis, birth weight <2500g (OR=5.48; CI=3.52–8.55; p<0.0001), gestational age ≤37 weeks (OR=3.24; CI=2.05–5.13; p<0.0001), Apgar score at 1 minute (OR=9.13; CI=5.75–14.46; p<0.0001) and at 5 minutes (OR=12.20; CI=7.19–28.05; p<0.0001), and maternal education up to primary school (OR=2.89; CI=1.43–5.86; p=0.0047) were the only exposures that indicated a higher chance of birth with CA. Conclusion: It was possible to estimate the prevalence and statistically analyze the data frequencies, confirming the association of factors related to CA. However, there is a need to improve the diagnosis of CA and to train healthcare professionals for the correct completion of the DNV. The information obtained in this study is important for planning public policies focused on the care, follow-up, prevention, and quality of life of NBs with CA.