Gender difference in the burden of urogenital congenital anomalies at global, regional, and national levels from 1990 to 2019: results from the Global Burden of Disease Study 2021

Aims: . Urogenital congenital anomalies(UCAs) involve both urinary tract and/or genital tract congenital malformations, which may cause severe neonatal death. This research aimed to reveal the latest magnitudes and temporal trends of geographical distribution for UCA burden and their gender difference to help develop more detailed prevention and intervention policies. Methods. The data for the disease burden of UCAs from 1990 to 2019 was exacted from the Global Burden of Disease Study 2019. The average annual percentage change was calculated to quantify the secular trends in age-standardized rates (ASRs) of UCA burden. Meanwhile, a cross-sectional comparison of the disease burden was made at the time points of 1990 and 2019. Results. In 2019, there were an estimated 1.13×10 6 [95% uncertainty interval (UI) 0.795-1.62] incident cases of UCA, 6.28×10 6 [95% UI 4.98-7.72] prevalent cases and 1.09×10 6 [95% UI 0.832-1.41] disabilityadjusted life years(DALYs) globally. For female UCAs, there were an estimated 0.559×10 6 [95% UI 0.392-0.790] incident cases, 3.17×10 6 [95% UI 2.53-3.88] prevalent cases and 0.438×10 6 [95% UI 0.302-0.604] DALYs. For male UCAs, there were an estimated 0.576×10 6 [95% UI 0.405-0.833] incident cases, 3.11×10 6 [95% UI 2.45-3.83] prevalent cases and 0.657×10 6 [95% UI 0.435- 0.925] DALYs. Conclusions. Our analysis confirms that UCAs are an underestimated public children's health concern. There was a slight upward trend of prevalence and incidence rates for UCAs, whereas the deaths rate and DALYs rates both showed relatively decreasing trends over the past 30 years globally. These substantial heterogeneities in the UCA burden worldwide and giant differences in the female and male cases highlight the need to detect the potentially influential factors for the UCA and devise suitable policies and provide specific clinical research.