Factors associated with unfavorable outcomes caused by Syphilis infection in pregnancy

Araújo, Maria Alix Leite; Andrade, Roumayne Fernandes Vieira; Barros, Valéria Lima de; Bertoncini, Paula Manuela Rodrigues Pinheiro

doi:10.1590/1806-93042019000200009

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Saúde Materno Infantil

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 19 (2) • Apr-Jun 2019 • https://doi.org/10.1590/1806-93042019000200009 copy

Factors associated with unfavorable outcomes caused by Syphilis infection in pregnancy

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze factors associated with unfavorable outcomes caused by syphilis infection in pregnancy.

Methods:

descriptive study carried out from May to August 2014, in public maternity hospitals. A questionnaire was administered to all women with a reactive Venereal Disease Research Laboratory (VDRL) test result and the data were supplemented with information from medical records and prenatal files. The bivariate analysis was performed using Pearson's chi-square or Fisher's exact test. For the multivariate analysis, was used through the logistic regression model.

Results:

a total of 137 puerperal women participated in the study, of which 14.3% had an unfavorable outcome, namely: stillbirth (2.9%), preterm birth (8.8%) and low birth weight (2.9%). In the multivariate analysis the odds ratio for the prevalence of an unfavorable outcome was three-fold higher in women who did not undergo a second VDRL test (OR=3,54; IC95% 1,04-15,33) and two-fold higher in women with a VDRL titer >1:8 (OR=2,15; IC95% 1,11-11,2).

Conclusions:

The unfavorable outcomes occurred in women who did not undergo the second VDRL test and those whose VDRL titer was >1:8 performed in the maternity hospital.

Key words
Syphilis, congenital; Syphilis; Pregnant Woman; Outcome

Variables	X̄ ± SD	N	%
Age range (in years)	24.6 ± 6.8
≤ 18		28	20.4
> 19		109	79.6
Schooling (in years)	7.5 ± 2.9
≤ 9		101	73.7
> 9		36	26.3
Family income (minimum wages) (n=129)	1.068.8 ± 691.1
≤ 1		56	43.4
> 1		73	56.6
Received prenatal care
Yes		134	97.8
No		03	2.2
Initiated Prenatal care (in weeks) (n=134)	15.5 ± 6.5
≤ 13		62	46.2
> 13		72	53.8
Number of Prenatal care consultations	6.2 ± 2.4
< 6		63	46.0
≥ 6		74	54.0
Was tested for VDRL during prenatal care (n=134)
Yes		123	91.8
No		11	8.2
Was tested for VDRL in the 1^st trimester (n=109)
Yes		54	49.5
No		55	50.5
1^st VDRLtitration (n=97)
≤ 1:8		60	61.9
> 1:8		37	38.1
Was tested for the 2^nd VDRL (n=123)
Yes		59	48.0
No		64	52.0
Was adequately treated
Yes		46	33.6
No		91	66.4
VDRL titration at the Maternity
≤ 1:8		105	76.6
> 1:8		32	23.4
Total		137	100.0

Variables	Unfavorable outcome				P
	Yes		No
	n	%	n	%
Age (in years)					0.01
≤ 29	20	100.0	91	77.8
> 29	00	0.0	26	22.2
Schooling (in years)					0.49
≤ 9	16	80.0	85	72.6
> 9	04	20.0	32	27.4
Self-reported of skin color/ethnicity					0.18
White	02	10.0	27	23.1
Non-white	18	90.0	90	76.9
Origin					0.32
Fortaleza	16	80.0	103	88.0
Countryside	04	20.0	14	12.0
Has a partner					0.10
Yes	13	65.0	95	81.2
No	07	35.0	22	18.8
Personal income (Minimum wages^a a Minimum wage at the time of the research: R$ 724.00. )					0.10
≤ 1	20	90.0	103	88.0
> 1	-	-	14	12.0
Family income (Minimum wages)					0.05
≤ 2	18	90.0	92	82.9
> 2	-	-	19	17.1

Variables	Unfavorable outcomes				p
	Yes		No
	n	%	n	%
Received prenatal care					0.35
Yes	19	95.0	115	98.3
No	01	5.0	02	1.7
Initiated prenatal care (in weeks)					0.10
≤ 13	04	26.7	54	49.1
> 13	11	73.3	56	50.9
Number of prenatal care consultations					0.03
< 6	13	68.4	49	42.6
≥ 6	06	31.6	66	57.4
Was tested for VDRL during prenatal care					0.69
Yes	17	89.5	106	92.2
No	02	10.5	09	7.8
1^st VDRL titration (n=84)					0.55
≤ 1:8	09	69.2	51	60.7
> 1:8	04	30.8	33	39.3
Was tested for the 1^st VDRL in the 1^st trimester					0.81
Yes	07	46.7	47	50.0
No	08	53.3	47	50.0
Was tested for the 2^nd VDRL (n=123)					0.03
Yes	04	23.5	55	51.9
No	13	76.5	51	48.1
Was treated adequately					0.37
Yes	05	25.0	41	35.0
No	15	75.0	76	65.0
VDRL titration at the Maternity					0.05
≤ 1:8	12	60.0	93	79.5
> 1:8	08	40.0	24	20.5

Variables			Unfavorable outcomes
			Non-adjusted			Adjusted
	n/N	%	OR	95%CI	p	OR	95% CI	p
Age (years)					0.01
≤ 29	20/20	14.5	1	-	-	-	-	-
> 30	91/117	77.7	0.31	-	-	-	-	-
Number of prenatal consultations					0.06
< 6	13/20	65.0	1	-	-	-	-	-
≥ 6	50/117	42.7	0.40	(0.12 - 1.18)	-	-	-	-
Was tested for the 2^nd VDRL test					0.05	3.54	(1.04 - 15.3)	0.02
Yes	55/117	47.0	2.58	(0.81 - 7.75)	-	-	-	-
No	04/20	20.0	1	-	-	-	-	-
2^nd VDRL titration					0.05	2.15	(1.11 - 11.2)	0.03
≥ 1:8	93/117	79.4	2.58	(1.04 - 15.33)	-	-	-	-
< 1:8	12/20	60.0	1	-	-	-	-	-

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
E-mail: revista@imip.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Authors' contributions

Araújo MAL and Bertoncini PMRP - designed, produced and reviewed the final version of the article. Andrade RFV and Barros VL - elaborated, critically reviewed the final version of the article. All the authors approved the final version of the manuscript.