FATORES SOCIODEMOGRÁFICOS ASSOCIADOS À INCIDÊNCIA DE FISSURAS LABIOPALATINAS NO BRASIL DE 2001 A 2022: UMA ANÁLISE ESPACIAL

Abstract

Cleft lip and palate are the most common birth defects in the skull and face. These malformations are congenital deformities that occur during the embryonic-fetal development period. In the literature, several factors have been found to be associated with the occurrence of cleft lip and palate, including smoking, alcoholism and the use of medication during pregnancy, as well as having a strong genetic component. The aim of the present study was to identify sociodemographic factors associated with the occurrence of cleft lip and palate in newborns in Brazil, from 2001 to 2022, by analyzing the spatial clustering of these factors in municipalities with high and low risk profiles. A retrospective ecological study was carried out using data from 2001 to 2022 extracted from the Live Birth Information System (SINASC). The spatial unit was a Brazilian municipality. The variables collected were maternal age and schooling, perinatal data and skin-color/ethnicity of the newborn. Thematic maps were created, incidence rates were calculated and local and global univariate and bivariate Moran indices were estimated to measure spatial autocorrelation between indicators. The rate of live births with cleft lip and palate in the period was 0.51/1000. The five Brazilian municipalities with the highest rates in the period were located in states in the South and Southeast regions. The high/high clusters included 234 municipalities, mainly concentrated in the South and Southeast. On the other hand, the low/low clusters included 431 municipalities, mainly concentrated in the Northeast region. There was a negative spatial relationship between the rate of births with cleft lip and palate and the percentage of pregnant women aged up to 19 (Moran's I = -0.162) and a positive relationship with those aged 35 or over (Moran's I = 0.164). There was a positive relationship between the rate of births with cleft lip and palate, the percentage of preterm births and the percentage of low-birth-weight births (Moran's I = 0.113) in neighboring municipalities. There was a positive relationship with the percentage of white births (Moran's I = 0.257), and a negative relationship with black and brown births (Moran's I = -0.071 and -0.244). There was no relationship with indigenous ethnicity. The findings of this study suggest that factors profiling pregnant women by age group, perinatal data and color/ethnicity of newborns may be related to clusters of municipalities with high and low incidences of births with cleft lip and palate concentrated in different regions of Brazil.