Fatores educacionais e assistenciais associados à prevalência da Sífilis Congênita em uma maternidade de referência em Belo Horizonte

Abstract

Aim: To estimate the presumptive prevalence of congenital syphilis and to investigate the educational and couseling associated factors. Methods: Case-control study with 180 postpartum women (Case group: 60 mothers; Control group: 120 mothers) performed in a maternity hospital in Belo Horizonte from September 2017 to September 2018. Independent maternal variables were grouped as follows: sociodemographic; clinical and obstetric history; educational and health care services in prenatal care. Data were obtained using interviews and medical records evaluation. Pearson's Chi-square test or Fisher's Exact test were used to evaluate the association strengthens. The odds ratio (OR) and the multivariate logistic regression analysis were performed to identify variable predictor factors. The study was approved by the Ethics Committee from Sofia Feldman Hospital and Federal University of Minas Gerais (2.197.498 and 2.144.587, respectively). Results: The prevalence of presumptive congenital syphilis was 4%. There was higher syphilis occurrence in women aging between 20-29 years old, who were brown-skinned, single and with incomplete basic education. Regarding the case group, 96.7% of women had prenatal care, 36.7% were diagnosed at maternity, 37.3% did not have partner support for the treatment and 55% of the partners were not treated. In the analysis of multivariate logistic regression, the syphilis treatment history was increased more than 5 times the children’s disease possible occurence in the current gestation and 24 times more likely to receive information and clarification about the risks of syphilis for the newborn during the prenatal period. The physician was responsible to obtain informations about the syphilis in more than half of responses and the approach was exclusively based on verbal exposure. Conclusion: Sociodemographic, educational and health assistance factors are associated with higher risks for syphilis in women. The results demonstrate the need to improve the control of syphilis during pregnancy through the quality of prenatal care and improvement in health education practices.