Temporal trends of the incidence rate of syphilis during pregnancy and congenital syphilis in São Paulo, Brazil, 2011-2023

Tendencia temporal de la tasa de incidencia de sífilis gestacional y congénita en San Pablo, 2011-2023

Objective  To analyze trends of syphilis during pregnancy and congenital syphilis, based on reported cases in São Paulo, Brazil, from 2011 to 2023.

Methods  Ecological time series study, based on data from Notifiable Health Conditions Information System records. The Prais-Winsten method was used to verify trends.

Results  125,776 cases of syphilis during pregnancy and 42,418 cases of congenital syphilis were reported. Average annual percentage change (95%CI) in the syphilis during pregnancy incidence rate was 18.68 (95%CI 16.57; 20.84), pvalue < 0.001; while for congenital syphilis it was 11.99 (95%CI 7.00; 17.22), p-value < 0.001.

Conclusion  Incidence rates of syphilis during pregnancy and congenital syphilis showed significant increasing trends, which may be related to the increase in the former during the diagnosis period (1st trimester), demonstrating increased testing among pregnant women, clinical classification at the time of diagnosis (latent syphilis), as well as inefficiency of adequate treatment when diagnosis is late.

Keywords
Syphilis; Syphilis, Congenital; Pregnant Women; Epidemiological Monitoring; Sexually Transmitted Diseases

Main results  Rising incidence rate trends were found for syphilis during pregnancy (SP) and congenital syphilis (CS) in the state of São Paulo, as well as a rising trend in diagno-sis of SP in the 1st trimester and clinical classification of latent syphilis.

Implications for services  Analysis of SP and CS enabled a better understanding of the general panorama of these cases, and will help to identify gaps in the healthcare system network, contrib-uting to better development of syphilis prevention strategies.

Perspectives  Based on the results found, we suggest continuing education for primary health care professionals, to identify infection, provide correct treatment and support edu-cational actions to prevent syphilis during pregnancy.