Factors associated with unfavorable outcomes caused by Syphilis infection in pregnancy

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.

Immunochromatography and laboratory serologies: an evaluation of immunodiagnoses in prenatal care

“…The vertical transmission and unfavorable outcomes to the pregnancy are proportional to the inadequate management of cases and to the losses associated with the diagnosis and to the early beginning of treatment for infectious pathologies (16)(17) .Considering that, the data is worrisome since it shows that, when confronted with signs of risk for infectious diseases in the gynecological and obstetric clinical exam, found by the professional responsible for the exam, the pregnant women were not advised and/or directed to undergo early serological examinations, even when diagnostic methods were available, such as the immunochromatography, which could bring these results in a short period of time.…”

“…Corroborating the results of this study, the South of Brazil is a region of the country in which the immunochromatography tests are still being implemented, and there are obstacles relative to the insufficiency of infrastructure, human resources, and difficulties for the construction of work flow that aid in the service provided (1,20) . The increase in the cases of congenital syphilis is a strong and current issue in the region, associated to late diagnoses and deficits in the clinical management of these pregnant women and their partners (17) . The slow implementation of the rapid testing validates delays in the diagnosis and in the treatment of infectious of pathologies that negatively impact the health of women and their children, as well as collective health.…”

Dados alarmantes sobre a notificação de sífilis congênita em uma capital do Norte brasileiro: um estudo transversal

“…A sífilis apresenta o Treponema pallidum como agente etiológico 1 e acomete mais de dois milhões de gestantes por ano 2,3 . A sífilis na gestação é deletéria para o feto e possui um alto risco de transmissão vertical.…”

“…A sífilis na gestação é deletéria para o feto e possui um alto risco de transmissão vertical. Para fins de classificação, considera-se sífilis congênita precoce quando os pacientes apresentam até dois anos de idade, após essa faixa etária é considerado sífilis congênita tardia 2 . O diagnóstico de sífilis congênita é realizado por uma avaliação epidemiológica criteriosa da situação materna e da avaliação clínico-laboratorial e exames de imagem na criança 4 .…”

A sífilis congênita no Brasil: uma realidade a ser enfrentada

“…As questões sociais estão intimamente relacionadas aos altos índices de sífilis congênita, mulheres com baixo nível de escolaridade que iniciaram o pré-natal atrasado com o mínimo de consultas e menor número de sorotipos contribuem para que esse quadro de saúde pública cresça drasticamente, sendo que a principal dificuldade de reduzir estes números seja a não adesão ao tratamento e o diagnóstico precoce (Araújo et al, 2019).…”