Mapping congenital anomalies incidence in the Brazilian health system from 2010 to 2023

To conduct an epidemiological study based on notifications of births with congenital anomalies recorded in the Brazilian Live Birth Information System (SINASC). We performed an observational study using SINASC data from 2010 to 2023. Annual birth rates, means, and time trends were analyzed. Congenital anomalies were classified according to the ICD-10 and a national priority list. Fisher’s Exact Test, with Bonferroni correction, was used to evaluate statistical associations between maternal-fetal characteristics and the presence of anomalies. A significant geographic disparity was observed, with São Paulo showing the highest mean annual incidence (1604.75 ± 241.63) and Maranhão the lowest (560.23 ± 163.19). Among priority anomalies, limb defects were the most frequent (60.41 ± 5.97 per 100,000 live births). Inferential analysis confirmed strong and consistent associations between congenital anomalies and key markers of neonatal compromise (5-minute Apgar score < 7, low birth weight and preterm birth), as well as advanced maternal age. Higher odds of registered anomalies in the Southeast region likely reflect differences in surveillance quality rather than true prevalence. The findings indicate an increasing trend and a geographic heterogeneity in the incidence of congenital anomalies in Brazil. This finding reinforces the need to strengthen surveillance and prevention strategies, with a focus on the high-risk places identified in this study.