Title : Factors associated with death from congenital syphilis in a municipality of Minas Gerais, Brazil, 2010 to 2018
Abstract:
Objective: To describe maternal and child factors associated with death from congenital syphilis.
Methods: Historical cohort study that evaluated syphilis notifications from 411 pregnant women and 289 children living in Betim, Minas Gerais, between 2010 and 2018. A Poisson regression was performed to assess the association between death from congenital syphilis and maternal and child factors.
Results: The profile of infected pregnant women was: 24.2% were up to 19 years of age, 47.7% were of a pardo or black race, 57.8% had eight or more years of education, 71.6% of the diagnoses were prenatal, 2.1% were properly treated, and 88.2% of the women’s partners did not seek treatment. Of the children who died, 71.9% of the mother's non-treponemal test upon delivery/curettage had a titer > 1:8. The estimated rates were: incidence of congenital syphilis, 5.2/1,000 live births; detection of syphilis in pregnant women, 7.4/1,000 live births; vertical transmission, 70.3%; lethality from congenital syphilis. 11.1%; and a mortality rate of 0.6/1,000 live births. There was a higher risk of death from congenital syphilis in pregnant women who were diagnosed in the first trimester, in children without treatment information in the notification, as well as in the result of the non-treponemal test in peripheral blood and cerebrospinal fluid. Children whose mothers were aged between 20 and 29 years had a 58% lower risk of dying from syphilis.
Conclusions: Syphilis remains a public health issue associated with missteps in prenatal care, late diagnosis, and an inadequate treatment of pregnant women and their partners.
