Congenital heart diseases: population-based cross-sectional study and spatial analysis, São Paulo, 2012-2022

To identify spatial clusters of risk and analyze maternal sociodemographic and obstetric factors associated with the occurrence of congenital heart diseases in the municipality of São Paulo between 2012 and 2022.

Population-based cross-sectional study and ecological spatial analysis using data from the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC) from 2012 to 2022 in the municipality of São Paulo. The outcomes were newborns diagnosed with congenital heart disease (International Statistical Classification of Diseases and Related Health Problems 10th Revision: Q20-Q28) and, as the comparison group, all other live births. Spatial scan analysis and logistic regression were used to estimate odds ratio (OR) and 95% confidence intervals (95%CI).

A total of 1,777,316 live births were recorded, of which 9,293 presented congenital heart diseases. Spatial analysis identified a cluster of cases in the municipality's northern area. Occurrence was associated with: residence in areas of spatial clustering (OR 2.97; 95%CI 2.82; 3.12), preterm pregnancy (OR 2.61; 95%CI 2.45; 2.78), triple or higher-order pregnancy (OR 2.60; 95%CI 1.57; 4.31), twin pregnancies (OR 1.14; 95%CI 1.00; 1.30), stable union (OR 1.44; 95%CI 1.37; 1.53), level of education between 1 to 7 years (OR 1.26; 95%CI 1.14; 1.39), 8 to 11 years (OR 1.20; 95%CI 1.11; 1.29), age between 35 to 49 years (OR 1.19; 95%CI 1.11; 1.28), and Asian (OR 1.81; 95%CI 1.47; 2.24) and Black race/skin color (OR 1.16; 95%CI 1.06; 1.27).

Individual maternal characteristics and territorial factors were associated with the occurrence of congenital heart diseases, revealing population profiles and priority areas for health actions.