Abstract
Objective: To identify the factors associated with hospitalizations due to congenital syphilis in neonates, based on the characteristics of prenatal care. Materials and method: A quantitative case-control study, conducted by applying a questionnaire to 65 puerperal women with their babies hospitalized from July to November 2017. The data were analyzed using logistic regression, according to the plan proposed in the hierarchical approach. Results: 20% of the hospitalizations were due to syphilis (cases) and 80% to other causes (control). The vulnerability risk (p = 0.036), previous history of sexually transmitted infection (p = 0,006), use of oral contraceptives (p = 0.011) and parity (p = 0.043) variables were statistically significant. The absence of the partner during the consultation (p = 0.028), failure to perform a rapid test for syphilis (p = 0.035) and educational activity for the partner (p = 0.033) were also associated with the occurrence of the outcome, in addition to the variables of the newborn: low birth weight (p = 0.025), not being on exclusive breastfeeding (p = 0.036) and not having had skin-to-skin contact (p = 0.043). Conclusions: Congenital syphilis has several risk factors for its occurrence. It was possible to observe that the assistance inequalities existing in care during the prenatal consultations directly reflect on the occurrence of this condition.
Highlights
Syphilis, an infection that is easy to diagnose and treat, still represents a serious public health problem
It was sought to identify the factors associated with the occurrence of congenital syphilis, in addition to proving that a qualified and timely prenatal care for the pregnant woman as well as for the partner would reduce the number of cases and of hospitalizations of neonates/children for the treatment
Low birth weight was associated with the occurrence of congenital syphilis, in line with the findings described in the literature, which emphasize that, in addition to reduced weight, prematurity, stillbirth, neurological sequelae, and death can be seen in children with this condition [11]
Summary
An infection that is easy to diagnose and treat, still represents a serious public health problem. Its reservoir is the contaminated human being, and transmission occurs mainly through sexual intercourse, without using a condom, with an infected individual or through vertical transmission during pregnancy [1]. Of the several diseases that can be transmitted during the pregnancy-puerperal cycle, syphilis has the highest rates of congenital infection, with a 70 % to 100 % possibility of vertical transmission of this condition in the primary and secondary stages of maternal syphilis, decreasing to 30 % in the late and tertiary latent phases [2]. While the Pan American Health Organization’s recommendation for Latin America and the Caribbean estimates 0.5 cases per 1,000 live births, the Brazilian rate is 6.5 [4], considered 13 times higher
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