Factors associated with unfavorable outcomes caused by Syphilis infection in pregnancy

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

doi:10.1590/1806-93042019000200009

Abstract

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.

Highlights

It is estimated that 1.5 million cases of syphilis occur worldwide in pregnant women every year,[1] in which such situations can have severe consequences for the newborn, as prematurity, stillbirths, early or late congenital manifestations and/or death of the newborn.[2]
The unfavorable outcomes occurred in women who did not undergo the second Venereal Disease Research Laboratory (VDRL) test and those whose VDRL titer was >1:8 performed in the maternity hospital
In Brazil, only in 2016, 19,846 cases of Congenital Syphilis (CS) were diagnosed and a total of 185 dead children under one year of age were reported to the Sistema de Informações sobre Mortalidade (SIM) (Mortality Information System), which corresponded to a coefficient mortality rate of 6.1 per 100,000 live births

Summary

Introduction

It is estimated that 1.5 million cases of syphilis occur worldwide in pregnant women every year,[1] in which such situations can have severe consequences for the newborn, as prematurity, stillbirths, early or late congenital manifestations and/or death of the newborn.[2]. In Brazil, only in 2016, 19,846 cases of CS were diagnosed and a total of 185 dead children under one year of age were reported to the Sistema de Informações sobre Mortalidade (SIM) (Mortality Information System), which corresponded to a coefficient mortality rate of 6.1 per 100,000 live births. The Northeast region registered 31% of all the reported cases and Ceará State is among the ten Brazilian States with the highest incidence rate of CS when compared to the national rate (8.6/1,000 live births).[4] These indicators exceeded the goal recommended by the World Health Organization (WHO),[5] by indicating the need for effective actions in confronting the problem

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Results

Discussion

Conclusion