Prenatal quality and clinical conditions of newborns exposed to syphilis

Abstract

Introduction: Syphilis is a sexually transmitted disease caused by Treponema pallidum, and results in considerable morbidity and mortality. Congenital syphilis can lead to miscarriage, prematurity, bone deformities, hearing loss and other important clinical changes. Objective: To analyze prenatal quality and clinical conditions of newborns exposed to syphilis in a public maternity hospital in Rio Branco-Acre. Method: This is a cross-sectional study that included 92 mothers diagnosed with syphilis during pregnancy, attended from July to December 2017. Two pregnant women had fetal death, and the final sample consisted of 90 newborns exposed to syphilis. An interview with the postpartum woman was used, analysis of the pregnant woman's card and search for information from the pregnant woman's records and newborns. It was considered confirmed case of syphilis in pregnant woman: a) All pregnant women who presented non-treponemal reagent test with any titration and reagent treponemal test performed during prenatal care; b) Pregnant woman with reagent treponemal test and nonreactive or unreacted nontreponemal test, without previous treatment record. To characterize congenital syphilis we considered: a) newborn whose mother was not diagnosed with syphilis during pregnancy and who presented a nontreponemal test reactive with any titration at the time of delivery; b) child whose mother was not diagnosed with syphilis during pregnancy and had a non-treponemal test reagent at the time of delivery; c) newborns whose mother presented a reactive treponemal test and a nonreactive non-treponemal test at the moment of delivery, without previous treatment record. Results: Most newborns were born in normal delivery (65.5%), 17.8% had acute fetal distress and 11.2% required resuscitation maneuvers. Prematurity occurred in 10% of births and 12.2% of them were small for gestational age. Complete prenatal care was performed by 29.5% of the mothers, following the recommendations of the Ministry of Health of seven visits to the Health Unit and or Health Professional. From the 90 pregnant women, 79 had a reactive treponemal test when admitted to the maternity ward. 29.3% of them performed the treatment properly. In the analysis about the treatment of the sexual partner, it was reported that 58% did not adhere to syphilis treatment. Conclusion: The prenatal quality of pregnant women with syphilis was lower than that recommended by the Brazilian Ministry of Health, although there are few cases of syphilis as the primary outcome in newborns with childbirth with mothers diagnosed with syphilis. Prenatal, newborn, syphilis in pregnancy, congenital syphilis.

Análise Epidemiológica Da Sífilis Gestacional No Brasil No Período De 2016-2020

“…Dados similares foram apresentados em outros estudos, como Cardoso et al (2018), D'Oliveira (2019), Meireles et al (2020) e Silveira et al (2021). Esta predominância de notificação dos casos de sífilis gestacional nessa faixa etária possui múltiplos fatores, como período reprodutivo, possuir múltiplos parceiros, não utilizar preservativo nas relações sexuais, não realizar o tratamento quer seja da gestante quer seja do parceiro, dentre outros (PASTRO et al, 2019;MEIRELES et al, 2020).…”

“…Desde 1986 a sífilis congênita se constitui como uma doença de notificação compulsória, enquanto a forma adquirida passou a ser notificada a partir de 2005. Por ser uma doença de notificação compulsória, todos os casos de gestantes com sífilis devem ser notificados, visto que a principal função da notificação de doenças é fornecer bases para que sejam implementadas políticas públicas de saúde que visem a promoção, proteção e controle da saúde da população (PASTRO et al, 2019;SILVEIRA et al, 2021).…”

Qualidade da assistência pré-natal associada à incidência de sífilis congênita: revisão integrativa

“…O acesso limitado às informações também foi explicitado na pesquisa de Gomes et al (2021) (Pastro et al, 2019).…”

30 years of the Journal of Human Growth and Development: scientific communication in the several areas of knowledge

“…Health education represents a strategy for the reorganization of health practices, allowing the exchange of experiences and reflections, in order to build knowledge, health habits, and health promoting actions. Health Education reveals itself as a tool for implementing the assumptions of health promotion, which is built collectively at a meeting that involves the various sectors, knowledge and subjects, valuing the users' choices as statements of autonomy 10,11,12 .…”