Sífilis na gestação e congênita : características maternas e desfechos perinatais na XII Região de Saúde de Pernambuco, 2017-2021

Abstract

Introduction: Syphilis has a significant impact during pregnancy and childhood, leading to complications such as premature birth, miscarriage, stillbirth, and morbidities that adversely affect children's health. Congenital syphilis is a public health problem worldwide. There are various obstacles during prenatal care hindering early diagnosis and appropriate treatment. Objective: To analyze cases of gestational and congenital syphilis according to maternal characteristics and perinatal outcomes in the XII Health Region of Pernambuco, from 2017 to 2021. Method: This study is an inferential, cross-sectional and documentary study, based on secondary data from notification forms for syphilis during pregnancy and congenital syphilis, Live Birth Certificate and Death Certificate obtained from the Notifiable Diseases Information System, the Live Births Information System and the Mortality Information System. The research was conducted in the XII Health Region of Pernambuco, from 2017 to 2021. The linkage technique between the systems was used in order to provide a single record for each case. The data were exported, tabulated and merged using Microsoft Office Excel program and the resulting spreadsheet was exported to SPSS. The study protocol was submitted for approval by the Research Ethics Committee. Results: The detection rate of syphilis during pregnancy was 17.42 cases per 1,000 live births, and the incidence rate of congenital syphilis was 9.47 cases per 1,000 live births. The majority of women reported with syphilis during pregnancy were between 20 and 34 years old (64.67%), non-white (86.8%), had less than eight years of schooling (85%), and were housewives (58.3%). Regarding reproductive characteristics and access to health services, most had no previous fetal losses (73.3%), were multiparous (73.0%), and had seven or more consultations (68.2%). The congenital syphilis was associated with the number of prenatal consultations (PR=0.59; CI=0.45-0.77); gestational trimester of diagnosis (PR=0.49; CI=0.33-0.73); treatment of the pregnant woman (PR=0.57; CI=0.41-0.81); and malformation (PR=2.64; CI=2.29-3.04). Treatment for gestational syphilis was associated with gestational age at delivery (PR=1.16; CI=1.00-1.36). Conclusions: The XII Health Region has a syphilis detection rate during pregnancy and incidence of congenital syphilis well above the recommended rate, with indicators exceeding the national rate. The information obtained can support the development of strategic health actions aimed at reducing the impacts of gestational and congenital syphilis, improving prenatal care, and consequently reducing cases of congenital syphilis.