Desfechos em fetos e recém-nascidos expostos a infecções na gravidez

Cross-sectional, quantitative study, carried out in a public maternity hospital in Maceió, Alagoas, Brazil. The sample consisted of 145 medical records of pregnant women admitted between 2015 and 2018 with possible vertically transmitted infections. Incomplete medical records or those that did not make it possible to describe fetal/neonatal exposure were excluded. The chi-squared test was used to verify the association between variables.

Results:

A greater occurrence of congenital syphilis was observed (28.8%). There was more than one outcome in the same individual, such as low birth weight (39%), respiratory distress (20.5%), oligohydramnios (20%), congenital malformation and small size for gestational age (10.8%). Maternal infections and the number of prenatal visits revealed an association with fetal/neonatal outcome (p ≤ 0.05).

Conclusion:

The data obtained indicate the occurrence of unfavorable fetal/neonatal outcomes when related to neonatal infections and indicate the need for strategies that strengthen the coping with vertical transmissions.

Descriptors:
Infections; Pregnancy; Vertical Infectious Disease Transmission; Infant, Newborn; Obstetric Nursing

Variable	Type	n	(%)
Gestational age	12 to 20 weeks	2	1.4
	21 to 36 weeks	82	56.5
	37 to 42 weeks	58	40
	Ignored	3	2.1
Number of prenatal appointments	None	21	14.5
	1 to 3 visits	30	20.7
	4 to 6 visits	39	26.9
	7 or more visits	30	20.7
	Ignored	25	17.2
Childbirth method	Vaginal	55	37.9
	Cesarean section	87	60
	Ignored	3	2.1

Variable	Type	n	(%)
Fetal sex	Female	68	46.6
	Male	66	45.2
	Ignored	12	8.2
Birth weight	Less than 500 g	1	0.7
	500 to 999 g	6	4.1
	1,000 to 1,499 g	12	8.2
	1,500 to 2,499 g	39	26.7
	2,500 to 3,999 g	70	47.9
	4,000 g and over	2	1.4
	Ignored	16	11

Variable	Type	n	(%)
Fetal/neonatal Outcome	Respiratory distress	36	20.5
	Oligohydramnios	35	20
	Congenital malformation	19	10.8
	Small size for gestational age	19	10.8
	Fetal death and at birth	18	10.2
	Intrauterine hypoxia	12	6.8
	Polyhydramnios	11	6.3
	Large size for gestational age	9	5.1
	Intrauterine growth restriction	8	4.5
	Perinatal hypoxia	3	1.7
	Intrauterine hypoxia	2	1.1
	Organ dysfunction	2	1.1
	Neonatal sepsis	2	1.1

Variable	Type	n	(%)
Maternal infection	Syphilis	101	69.7
	Human immunodeficiency virus	18	12.4
	Human immunodeficiency virus + syphilis	9	6.2
	Zika virus	8	5.5
	Hepatitis B	6	4.1
	Hepatitis C	2	1.4
	Toxoplasmosis	1	0.7
Congenital infection	Syphilis	42	28.8
	Human immunodeficiency virus	1	0.7
	Uninfected or without laboratory diagnosis	103	70.5

Variable	Category	Fetal/neonatal outcomes		p ^ chi-squared (χ2).
Variable	Category	Yes (%)	No (%)	p ^ chi-squared (χ2).
Maternal Infection	Only syphilis	88 (87.1)	13 (12.9)	0.012
Maternal Infection	Outros^* * Simultaneous infections by HIV + syphilis, by HIV, hepatitis B and C, Zika virus and toxoplasmosis;	31 (68.9)	14 (31.1)	0.012
Number of prenatal appointments	< 4 appointments	46 (88.5)	6 (11.5)	0.026
Number of prenatal appointments	≥ 4 appointments	49 (71)	20 (29)	0.026

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[1] Corresponding author: Kerolayne Aguiar Gomes da Silva. E-mail: enfkerolayneaguiar@gmail.com