Abstract
ABSTRACTObjective: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.
Highlights
Worldwide estimates in 2012 indicated 927,936 maternal infections due to active syphilis and 350,915 adverse pregnancy outcomes[1]
We found an association of non-white skin color/ethnicity, low educational level, and companion absence during prenatal care with syphilis during pregnancy, as well as the occurrence of prematurity and low birth weight associated with gestational syphilis
The results of this study show that there is still much progress to be made towards the World Health Organization (WHO) goal of eliminating congenital syphilis as a public health problem
Summary
Worldwide estimates in 2012 indicated 927,936 maternal infections due to active syphilis and 350,915 adverse pregnancy outcomes[1]. This infection represents a serious public health problem, associated with perinatal complications such as congenital syphilis. According to the Epidemiological Bulletin of Syphilis (2016), 33,365 cases of syphilis during pregnancy were reported in Brazil in 2015, reaching a detection rate of 11.2 syphilis cases in pregnant women per thousand live births. The rate in 2010 was 3.3 cases per thousand live births, showing an increase of 202% in five years. The data are even more worrying in the South and Southeast regions of the country; the detection rate was 15.1 and 12.6 syphilis cases in pregnant women per thousand live births, respectively, exceeding the national rate*. In the last ten years, there has been a progressive increase in the incidence rate of congenital syphilis, from 2.0 cases per thousand live births in 2006 to 6.5 cases per thousand live births in 2015*
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