# Trends in Gastroschisis in the State of Paraná, Brazil: A Study of Incidence, Mortality, and Associated Factors (2013–2024)

## TL;DR

This study examines the incidence and mortality trends of gastroschisis in Paraná, Brazil, from 2013 to 2024, highlighting the need for improved maternal and neonatal care to reduce deaths.

## Contribution

The study provides a detailed analysis of gastroschisis trends in Paraná, Brazil, using population data to inform public health policies and healthcare improvements.

## Key findings

- Gastroschisis incidence in Paraná decreased by 39.5% from 2013 to 2024.
- The case fatality rate for gastroschisis was 36.5%, indicating a critical public health concern.
- Mothers of children with gastroschisis were predominantly young, had low education, and gave birth via cesarean.

## Abstract

Public health relevance—How does this work relate to a public health issue?
This study with population data is fundamental for public health because it acts as an indicator of the quality of maternal and child care and the effectiveness of surveillance policies in Paraná.The work qualifies the use of national systems, which are: the Live Birth Information System (SINASC) and the Mortality Information System (SIM), which are important national database systems.

This study with population data is fundamental for public health because it acts as an indicator of the quality of maternal and child care and the effectiveness of surveillance policies in Paraná.

The work qualifies the use of national systems, which are: the Live Birth Information System (SINASC) and the Mortality Information System (SIM), which are important national database systems.

Public health significance—Why is this work of significance to public health?
This work is important for public health because it allows for an accurate diagnosis of conditions related to children born with gastroschisis and its lethality.The 36.5% lethality rate associated with gastroschisis is a critical warning sign.

This work is important for public health because it allows for an accurate diagnosis of conditions related to children born with gastroschisis and its lethality.

The 36.5% lethality rate associated with gastroschisis is a critical warning sign.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
The healthcare system needs an adequate network that enables prenatal care and delivery of children with gastroschisis in hospitals that are referral centers for neonatal intensive care and efficient pediatric surgery services.With improved care for pregnant women and children with gastroschisis, mortality rates can decrease.

The healthcare system needs an adequate network that enables prenatal care and delivery of children with gastroschisis in hospitals that are referral centers for neonatal intensive care and efficient pediatric surgery services.

With improved care for pregnant women and children with gastroschisis, mortality rates can decrease.

This population-based study aimed to analyze the annual incidence and case fatality trends, and the clinical-epidemiological profile of gastroschisis in the state of Paraná, Brazil, between 2013 and 2024. Specifically, temporal trends in annual incidence and mortality rates related to gastroschisis were examined. Maternal, gestational, and neonatal characteristics were analyzed. Data from the Live Birth Information System and the Mortality Information System were analyzed using polynomial regression modeling. During the study period, 1,798,727 live births were recorded, including 491 cases of gastroschisis and 179 related deaths. The mean incidence was 2.73 per 10,000 live births. A significant 39.5% decrease over the study period was observed (p < 0.001). The case fatality rate was 36.5%. The mothers of children with gastroschisis were: young mothers (<25 years old; 77%), with low education (87.7%) and no partner (59.1%). High frequencies of cesarean deliveries (84.3%), prematurity (57.3%), low birth weight (63.7%), and low Apgar scores were also observed. The profiles of the mothers and children at birth were unfavorable when compared to the population of live births. Gastroschisis incidence in Paraná declined significantly from 2013 to 2024. While the annual incidence showed a decreasing trend, mortality fluctuated. The persistently high case fatality rate underscores the need for public policies focused on prenatal care and specialized neonatal management.