Global, Regional, and National Differences in the Incidence and Mortality of Digestive Congenital Anomalies from 1990 to 2021, with Projections for Future Trends

Baihui Yan^*Wei LiPeng Li

• The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China

Digestive congenital anomalies (DCA) remain a major but unevenly distributed cause of death and disability worldwide. We quantified global, regional and national trends in DCA prevalence, mortality and disability-adjusted life years (DALYs) from 1990 to 2021 by analysing data from the Global Burden of Disease 2021 study. Age-standardised rates and estimated annual percentage changes were calculated for five age groups: <1 year, 2–4 years, 5–14 years, 15–19 years, and 20–54 years. Future trajectories up to 2036 were projected with an autoregressive integrated moving-average model. In 2021 infants accounted for the largest share of the burden, although their absolute incidence declined by 9 % relative to 1990. High-socio-demographic index (SDI) regions achieved pronounced reductions in both mortality and DALYs, whereas low-SDI regions showed rising trends. Projections indicate a continued global increase in prevalence across all age groups, but a further decline in infant and child mortality. Our findings highlight persistent inequities and underscore the need for strengthened maternal–neonatal services, early surgical access, and targeted resource allocation in low-income settings. This integrated epidemiological overview provides an evidence base for prioritising DCA within national child-health agendas and monitoring progress towards Sustainable Development Goal targets.