Fatores sociodemográficos, comportamentais e clínicos associados à sífilis em parturientes com recém-nascidos prematuros : um estudo de caso-controle

• Autor(a) principal: Cunha, Carla Baroni
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/7162
• topic: Syphilis; Parturient; Preterm delivery; Premature newborn; Parturiente; Parto pré-termo; Recém-nascido prematuro; Doenças Infecciosas e Parasitárias; Sífilis; Parto (Obstetrícia); Prematuros; 61

Background: Syphilis remains an importante public health problem. It is estimated that 2 million pregnant women are infected annually worldwide. Inadequate or lack of a treatment may have serious adverse outcomes such as prematurity, low birth weight, early pregnancy loss or neonatal death. Objective: To evaluate sociodemographic, behavioral and clinical factors for syphilis in pregnant women with premature newborns. Methods: A case-control study was carried out between June 2012 and June 2013. A total of 404 pregnant women in preterm birth were attended at University Hospital Cassiano Antonio Moraes (HUCAM) in Vitória/ES. Out of these 404 parturient women, 16 were diagnosed as positive for syphilis (cases), and 388 were negative for syphilis, and out of these, 64 were selected using the criteria of similarity by age and city of residence in order to make similar groups. Results: The maternal mean age was 24.01 years (SD = 7.36). Among the pregnant women tested positive for syphilis, 87.5% had eight or less years of study (p = 0.005); 68.8% were single (p = 0.009); 56.3% had the first sexual intercourse between 14 and 17 years old (p = 0.042); 81.2% of the fetuses were born alive (p = 0.052); 75.0% weighed between 1500 and 2499g (p = 0.006); and 37.5% of the pregnant women had meconium in the amniotic fluid (p = 0.003). For the control group, 51.6% had eight or more years of study; 68.8% were married; 53.1% had the first sexual intercourse between 14 and 17 years old; 96.9% of the fetuses were born alive; 35.9% weighed less than 1500g; and 93.8% of the pregnant women had amniotic fluid without meconium. Multivariate analysis showed significant association of syphilis with the presence of meconium in the amniotic fluid [OR 7.9 (95% CI: 1.30 - 47.98) p=0.025] for preterm birth. Conclusions: This study showed an association between the presence of meconium in the amniotic fluid and syphilis in cases of premature births attended at HUCAM. Furthermore, it should be emphasized the necessity of screening for syphilis in antenatal care, as recommended by the Health Ministry of Brazil, especially in cases of preterm delivery.