Abstract
Abstract Objectives: to describe the occurrence of gestational and congenital syphilis in Guarapuava-PR, according to maternal, neonatal characteristics and outcome of cases. Methods: cross-sectional study, retrospective, held in Guarapuava/PR, with secondary data collected in the laboratory of clinical analyses and information system of Compulsory Notification, collected between October 2015 and August/2016, the variables were described through absolute and relative frequencies. Results: of the 40 newborn (NB) children ofpregnant women with syphilis, 30.0% had congenital syphilis. The variables that were associated with were: gestational quarter of positive examination (p=0.008), number of antenatal consultations (p=0.041), gestational risk stratification (p= 0.041) and treatment of partner (p<0.001). The variables that were associated with the occurrence of congenital syphilis were: risk classification at birth (p=0.004) and examination VDRL in the peripheral blood of the NB (p=0.004). Conclusions: reinforcing prenatal, with the early capture of the pregnant woman by basic care, expansion of the diagnostic coverage and timely and adequate treatment of the pregnant woman and partner, as a prophylactic measure of a possible reinfection.
Highlights
The study population consisted of pregnant women with syphilis, residents in the city and selected from examinations Venereal Disease Research Laboratory (VDRL) nontreponemal positive test (Jan the Dec/2014)
62.5% women were classified as havinghigh-risk pregnancy and more than seven prenatal consultations, which initiated in the first quarter (90.0%)
It was during this period of gestation that occurred the first VDRL test (77.5%), being that most pregnant women (55.0%) conducted an examination and 67.5% were treated for syphilisdates, as their partners, 52.5 percent were not treated
Summary
Even with clinical evidence and epidemiological data, syphilis remains a public health problem worldwide.[1,2,3,4] Worldwide, 1,360,000 of pregnant women were infected, 80% of these were assisted in prenatal programs, 38% showed some adverse result, as fetal and neonatal mortality, prematurity or low birth weight and congenital infection.[5,6]. The Pan American Health Organization (PAHO) has set the reduction of incidence of congenital syphilis to ≤ 0.5 cases per 1,000 alive until 2015.7 This level has not been achieved.On the contrary, the cases feature and configure itself as an epidemic, with an incidence of 1.3/1,000 live births in the Americas[7] and 6.5/1,000 in Brazil.[8] In the period from 2005 to 2016, were notified in the Notification Aggravation Information System (SINAN) 169,546 cases of syphilis in pregnant women in Brazil.[8]. It is considered that underreporting is still an obstacle for epidemiological surveillance.[2,3] In the State of Paraná, from 1,117 diagnosed pregnant women, 455 cases of congenital syphilis were reported.[9]
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