Global, regional, and national differences in the incidence and mortality of digestive congenital anomalies from 1990 to 2021, with projections for future trends

Introduction Digestive congenital anomalies (DCA) remain a major yet unevenly distributed cause of death and disability worldwide. We aimed to quantify global, regional, and national trends in DCA prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. Methods We analyzed Global Burden of Disease 2021 data. Age-standardized 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 to 2036 were projected using an autoregressive integrated moving average (ARIMA) model. Results 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, alongside further declines in infant and child mortality. Discussion Persistent inequities 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 prioritizing DCA within national child-health agendas and for monitoring progress toward Sustainable Development Goal targets.