Frequency of congenital syphilis and characteristics of affected mother-newborn dyads cared for at the District Hospital of Presidente Franco, Paraguay
DOI:
https://doi.org/10.5281/zenodo.22146573Keywords:
congenital syphilis, infectious complications of pregnancy, vertical transmission of infectious disease, prenatal care, socioeconomic factors, ParaguayAbstract
Introduction: Untreated maternal syphilis causes fetal loss, stillbirth, prematurity, neonatal death and congenital syphilis, preventable outcomes with early prenatal screening and penicillin treatment. In Paraguay the burden is high and the event is underreported. The aim was to describe the frequency of congenital syphilis among live births and the profile of affected mothers at the District Hospital of Presidente Franco, Paraguay, first semester of 2024. Materials and methods: Observational, descriptive and retrospective study based on records from the neonatology service and hospital statistics department. The proportion of congenital syphilis among live births and, in affected mothers, age, number of prenatal visits, socioeconomic level and schooling were described using frequencies, without hypothesis testing. Results: Of 457 live births between January and June 2024, 10 had congenital syphilis (2.19%). In 8 of the 10 mothers age was 23 years or less; 4 had 2 prenatal visits or fewer and another 4 had 6 or more; all were of low socioeconomic level, with primary schooling in 6 and secondary in 4. Conclusions: Congenital syphilis was frequent among live births in this district hospital, and affected mothers were young, of low socioeconomic level and often with insufficient prenatal care. The findings support dual HIV and syphilis screening at first contact and repetition in the third trimester, treatment of every seroreactive pregnant woman and her partner and improved record keeping, but do not allow estimation of population incidence.References
Peeling RW, Mabey D, Kamb ML, Chen XS, Radolf JD, Benzaken AS. Syphilis. Nat Rev Dis Primers. 2017;3:17073. https://doi.org/10.1038/nrdp.2017.73
Kojima N, Klausner JD. An update on the global epidemiology of syphilis. Curr Epidemiol Rep. 2018;5(1):24-38. https://doi.org/10.1007/s40471-018-0138-z
Korenromp EL, Rowley J, Alonso M, Mello MB, Wijesooriya NS, Mahiané SG, et al. Global burden of maternal and congenital syphilis and associated adverse birth outcomes-estimates for 2016 and progress since 2012. PLoS One. 2019;14(2):e0211720. https://doi.org/10.1371/journal.pone.0211720
Gomez GB, Kamb ML, Newman LM, Mark J, Broutet N, Hawkes SJ. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ. 2013;91(3):217-26. https://doi.org/10.2471/BLT.12.107623
Blencowe H, Cousens S, Kamb M, Berman S, Lawn JE. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality. BMC Public Health. 2011;11 Suppl 3:S9. https://doi.org/10.1186/1471-2458-11-S3-S9
Hawkes SJ, Gomez GB, Broutet N. Early antenatal care: does it make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis. PLoS One. 2013;8(2):e56713. https://doi.org/10.1371/journal.pone.0056713
Braccio S, Sharland M, Ladhani SN. Prevention and treatment of mother-to-child transmission of syphilis. Curr Opin Infect Dis. 2016;29(3):268-74. https://doi.org/10.1097/QCO.0000000000000270
Valderrama J, Zacarías F, Mazin R. Sífilis materna y sífilis congénita en América Latina: un problema grave de solución sencilla. Rev Panam Salud Publica. 2004;16(3):211-7. https://doi.org/10.1590/s1020-49892004000900012
Heath K, Alonso M, Aguilar G, Samudio T, Korenromp E, Rowley J, et al. WHO method for estimating congenital syphilis to inform surveillance and service provision, Paraguay. Bull World Health Organ. 2022;100(3):231-6. https://doi.org/10.2471/BLT.20.271569
Ovelar P, Rolón R, Rumich A, Aguilar G, Samudio T, Cusihuamán A, et al. Situación de la sífilis congénita en Paraguay utilizando datos del sistema de información perinatal (SIP Plus). Rev Inst Med Trop. 2024;19(1):10-20. https://doi.org/10.18004/imt/2024.19.1.10
Pascoal LB, Carellos EVM, Tarabai BHM, Vieira CC, Rezende LG, Salgado BSF, et al. Maternal and perinatal risk factors associated with congenital syphilis. Trop Med Int Health. 2023;28(6):442-53. https://doi.org/10.1111/tmi.13881
Domingues RMSM, Leal MC. Incidência de sífilis congênita e fatores associados à transmissão vertical: dados do estudio Nascer no Brasil. Cad Saude Publica. 2016;32(6):e00082415. https://doi.org/10.1590/0102-311X00082415
Silva ÂAO, Leony LM, Souza WV, Freitas NEM, Daltro RT, Santos EF, et al. Spatiotemporal distribution analysis of syphilis in Brazil: cases of congenital and syphilis in pregnant women from 2001-2017. PLoS One. 2022;17(10):e0275731. https://doi.org/10.1371/journal.pone.0275731
Cooper JM, Sánchez PJ. Congenital syphilis. Semin Perinatol. 2018;42(3):176-84. https://doi.org/10.1053/j.semperi.2018.02.005
McDonald R, O'Callaghan K, Torrone E, Barbee L, Grey J, Jackson D, et al. Vital signs: missed opportunities for preventing congenital syphilis - United States, 2022. MMWR Morb Mortal Wkly Rep. 2023;72(46):1269-74. https://doi.org/10.15585/mmwr.mm7246e1
Garcia LN, Destito Solján A, Moroni S, Falk N, Gonzalez N, Moscatelli G, et al. Congenital syphilis in Argentina: experience in a pediatric hospital. PLoS Negl Trop Dis. 2021;15(1):e0009010. https://doi.org/10.1371/journal.pntd.0009010
Trinh T, Leal AF, Mello MB, Taylor MM, Barrow R, Wi TE, et al. Syphilis management in pregnancy: a review of guideline recommendations from countries around the world. Sex Reprod Health Matters. 2019;27(1):1691897. https://doi.org/10.1080/26410397.2019.1691897
Rac MW, Revell PA, Eppes CS. Syphilis during pregnancy: a preventable threat to maternal-fetal health. Am J Obstet Gynecol. 2017;216(4):352-63. https://doi.org/10.1016/j.ajog.2016.11.1052
Harrison J, Lind P, Sawleshwarkar S, Pasupathy D, Yapa HM. Rapid systematic review of interventions to improve antenatal screening rates for syphilis, hepatitis B, and HIV in low- and middle-income countries. Int J Gynaecol Obstet. 2024;166(1):3-26. https://doi.org/10.1002/ijgo.15425
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Copyright (c) 2025 Daniel Vitor Belarmino Venancio, Gilson Gonçalves da Fonseca, Raissa Helena Paulinelli Zico Venancio, Makarena Soledad Velázquez Yegros (Autor/a)
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