Syphilis in during pregnancy: association of maternal and perinatal characteristics in a region of southern Brazil

Padovani, Camila; Oliveira, Rosana Rosseto de; Pelloso, Sandra Marisa

doi:10.1590/1518-8345.2305.3019

Acessibilidade / Reportar erro

Brasil

Revista Latino-Americana de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Latino-Am. Enfermagem 26 • 2018 • https://doi.org/10.1590/1518-8345.2305.3019 copy

Syphilis in during pregnancy: association of maternal and perinatal characteristics in a region of southern Brazil¹ 1 Paper extracted from master’s thesis “Syphilis in pregnancy and its association with perinatal outcome”, presented to Departamento de Enfermagem, Universidade Estadual de Maringá, Maringá, PR, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the prevalence of syphilis in during pregnancy and its association with socioeconomic characteristics, reproductive history, prenatal and labor care, and newborn characteristics.

Method:

A retrospective, cross-sectional study based on gestational and congenital syphilis reports. A (records) linkage was performed in the Brazilian databases: “Information System for Notifiable Diseases” (Sistema de Informação de Agravos de Notificação - SINAN); “Live Births Information System” (Sistema de Informação sobre Nascidos Vivos - SINASC); and “Mortality Information System” (Sistema de Informação sobre Mortalidade - SIM).

Results:

The prevalence of gestational syphilis was 0.57%. The following associations of syphilis in pregnancy were found: non-white skin color/ethnicity (PR=4.6, CI=3.62-5.76); low educational level (PR=15.4; CI=12.60-18.86); and absence of prenatal care (PR=7.4, CI=3.68-14.9). The perinatal outcomes associated with gestational syphilis were prematurity (PR=1.6 CI=1.17-2.21) and low birth weight (PR=1.6; CI=1.14-2.28). Two deaths from congenital syphilis, one death from another cause and five stillbirths were reported.

Conclusion:

The results signify a long way until reaching the World Health Organization’s goal of eradicating congenital syphilis.

Descriptors:
Syphilis; Pregnancy; Risk Factors; Syphilis, Congenital; Sexually Transmitted Diseases; Maternal and Child Health

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding Author: Camila Padovani Universidade Estadual de Maringá. Departamento de Enfermagem Av. Colombo, 5790 CEP: 87020-900, Maringá, PR, Brasil E-mail: cah_padovani@hotmail.com

		N* (270)	%	PR^†	CI^‡ (95%)
Maternal age
	≤ 19 years	61	22.59	1.7	1.30-2.31
	20 to 34 years	182	67.41	-
	35 or older	27	10.00	0.8	1.27-0.56
Skin color/ethnicity
	White	162	60.00	-
	Non-white	105	38.89	4.6	3.62-5.76
	Ignored	3	1.11
Maternal educational level
	Illiterate	2	0.74	122.3	85.34-inf.^§
	<8 years	86	31.85	15.4	12.60-18.86
	≥8 years	151	55.93
	Ignored	31	11.48	-
Occupation
	Yes	74	27.41	-
	No	151	55.93	4.5	3.50-5.83
	Student	13	4.81	4.6	2.69-7.90
	Ignored	32	11.85	4.3	2.91-4.49
Previous live births^║¶
	Yes	158	58.52	1.2	1.10-1.79
	No	112	41.48	-
Previous Fetal loss/abortion^║¶
	Yes	60	22.22	1.7	1.27-2.24
	No	210	77.78	-
Parity^§║
	Primiparous	95	35.19	-
	Multiparous	175	64.81	1.9	1.45-2.37
Prenatal care during pregnancy**
	Yes	138	93.88	-
	No	6	4.08	7.4	3.68-14.97
	Ignored	3	2.04
Prenatal consultations^¶**
	< 7	75	27.78	1.8	1.40-2.38
	≥ 7	195	72.22	-
Type of delivery^║¶
	Cesarean section	154	57.04	-
	Vaginal delivery	116	42.96	2.4	1.91-3.06

		N*	%
Diagnosis of syphilis^†
	During prenatal care	115	78.23
	During delivery/curettage	12	8.16
	After delivery	14	9.52
	Not performed/Ignored	6	4.09
VDRL^‡ during prenatal care
	Reactive	225	83.33
	Not reactive	32	11.85
	Not performed/Ignored	13	4.82
FTA-Abs^§ during prenatal care
	Reactive	169	62.59
	Not reactive	42	15.56
	Not performed/Ignored	59	21.85
VDRL^‡ during delivery/curettage^†
	Reactive	110	74.83
	Not reactive	25	17.01
	Not performed/Ignored	12	8.16
FTA-Abs^§ during delivery/curettage^†
	Reactive	61	41.50
	Not reactive	15	10.20
	Not performed/Ignored	71	48.30
Gestational trimester
	First	106	39.26
	Second	84	31.11
	Third	71	26.30
	Ignored	9	3.33
Clinical classification
	Primary	165	61.11
	Secondary	25	9.26
	Tertiary	14	5.19
	Latent	21	7.78
	Ignored	45	16.67
Treatment of the pregnant women
	Adequate	125	46.30
	Inadequate/Not performed	145	53.70
Treatment of the partner
	Yes	97	35.93
	No/Ignored	173	64.07
Reason for not treating the partner^║
	He no longer has contact with the pregnant woman	43	15.93
	He was not notified/invited for treatment	15	5.56
	He was notified/invited, but he did not show up	22	8.15
	He refused treatment	5	1.85
	Non-reactive serology	28	10.37
	Another reason	78	28.89
	Ignored	79	29.26

Newborn characteristics		N*	%	PR^†	CI^‡ (95%)
Gender^§║
	Female	131	48.52	-
	Male	139	51.48	1.0	0.80-1.29
Gestational age^§║
	< 37 weeks	46	17.04	1.6	1.17-2.21
	≥ 37 weeks	224	82.96	-
Birth weight^§║
	< 2,500 g	37	13.70	1.6	1.14-2.28
	≥ 2,500 g	233	86.30	-
Apgar 1^║
	< 7	21	7.87	1.2	0.80-1.94
	≥ 7	246	92.13	-
Apgar 5^║
	< 7	3	1.12	1.2	0.37-3.63^¶
	≥ 7	264	98.88	-
Malformation^§║
	Yes	3	1.12	1.4	0.45-4.37^¶
	No	264	98.88	-

Characteristics of newborn care	N* (147)	%
Age at diagnosis (days)^†
< 2	118	80.27
2 to 28	21	14.29
≥ 28	8	5.44
Results from the VDRL^‡ of peripheral blood^†
Reactive	79	53.74
Not reactive	39	26.53
Not performed	21	14.29
Ignored	8	5.44
Results from the VDRL^‡ of the cerebrospinal fluid^†
Reactive	6	4.08
Not reactive	52	35.37
Not performed	51	34.69
Ignored	38	25.85
Alterations in long-bone X-ray^†
Yes	5	3.40
No	62	42.18
Not performed	42	28.57
Ignored	38	25.85
Case evolution^†
Alive	131	89.12
Death by congenital syphilis	2	1.36
Death due to other causes	1	0.68
Stillborn	5	3.40
Ignored	8	5.44
Treatment plan^†
Crystalline Penicillin G 100,000 to 150,000 Ul/kg/day	27	18.37
Procaine Penicillin G 50,000 Ul/kg/day	3	2.04
Benzathine Penicillin G 50,000 Ul/kg/day	5	3.40
Other plan	26	17.69
Not performed	70	47.62
Ignored	16	10.88