Spatial analysis of birth defects in Brazil based on the human development index (HDI): an ecological study

Abstract Globally, between 2–4% of live births present Birth Defects (BDs) each year. The highest rates of mortality and morbidity caused by BDs are in low and middle-income countries. In Brazil, they are the second cause of infant mortality. Therefore, the aim of this study is to report the spatial distribution of the incidence of BDs at birth and infant mortality rate due to BDs (IMR-BDs) with the Human Development Index (HDI), and the cases of infant hospitalizations in Brazil. Data were extracted from an anonymous public database, and geospatial analysis was performed using the Global Moran Index statistic. We applied the Kruskal-Willis test and the Dunn test for multiple comparisons between regions and states. We found over 11.4 million births, out of which 99,653 had BDs (incidence: 87.05/10,000 live births); 30,357 infant deaths from BDs were recorded (26.52/10,000 live births). The analysis of the spatial correlation between BDs and the HDI-2010 values for each region/state revealed a statistically significant association in two scenarios: incidence of BDs and IMR-BDs vs. HDI-2010 (p = 0.005). There was an average of 22,710 infant hospitalizations due to BDs, and the average cost for infant hospitalizations was USD $ 30,372.24. The data call attention for the need to establish services and surveillance for prevention and to improve the goals of reducing IMR-BDs and costs with child hospitalizations due to BDs. Detection of BDs at a spatiotemporal level and their geographic distributions are used to support public administrators in managing affected children.