Qualidade das declarações de óbito perinatal com menção de sífilis congênita no Brasil e sua evolução, 2001-2002 e 2012-2013

Abstract

Introduction: Syphilis is a disease of great importance in Public Health. Congenital syphilis (SC) occurs when the pregnant woman conveys syphilis to the concept via transplacental, at any stage of pregnancy. Among the diseases of vertical transmission congenital syphilis is one of the diseases with the highest rates of transmission to the concept in the country and is considered a sentinel indicator in the quality of prenatal care. Objective: To evaluate the quality of information on death certificates (DO) with mentions of congenital syphilis (SC) in perinatal deaths in Brazil (2001/02 and 2012/13). Methods: Cross - sectional study with data from the Mortality Information System (SIM) of early fetal and neonatal deaths in Brazil. Preterm and perinatal fetal, preterm and perinatal mortality rates were calculated, percentage of incompleteness by selected variables, baseline cause and multiple cause (CB / CM), among other indicators. The original underlying cause was compared to the underlying cause after investigation (2012/13). Results: In 2001/02 and 2012/13, there were 330 and 933 perinatal deaths, respectively, with SC mentions; The perinatal mortality rate rose from 4.2 to 12.8 per 100,000 total births. The completion of the main required fields has improved. The CB / CM ratio was 0.8 for SC, indicating recovery from this cause with multiple causes. SC's participation as the basic cause of death increased post-investigation, from 31.2% to 85.4% (fetal deaths) and from 54.5% to 76.2% (early neonates). Conclusion: The methodology of multiple causes of death was important for the more accurate identification of congenital syphilis as one of the outcomes of early fetal and neonatal deaths. The use of multiple causes of death allowed the analysis of all perinatal deaths with SC mentions, with a recovery of 70 to 80% of the deaths, which is important to know the magnitude of the disease. The perinatal mortality rate due to SC increased in Brazil. There was an improvement in the filling of the DO, but the filling fields related to the mother's schooling, number of children born and gestational age had incompleteness percentage higher than 10%, and there was room for improvement in the collection and recording of this information. It is important to highlight that in addition to the other available databases, such as SINASC, the use of hospital records and records of the Family Health Program team can serve as tools for improving the quality of health information.