Sífilis congênita: incidência em recém-nascidos

Abstract

Objective

To determine the incidence of congenital syphilis among newborns in the maternity ward of a public hospital. Methods: This study was conducted at the maternity ward of Fundação Santa Casa de Misericórdia do Pará, Brazil, from May to September 1996. We interviewed 361 mothers, and their newborns were physically examined. Serum samples from both mothers and neonates were tested with three methods: VDRL, FTA - Abs, and ELISA IgM. The diagnosis of congenital syphilis was established according to the criteria defined by the Brazilian Health Ministry in 1993. Results: The rate of congenital syphilis was 9.1% (33); 14 newborns had one or more signs of the disease: prematurity, hepatomegaly, stillbirth, splenomegaly, perinatal death, abdominal distention, nasal stuffiness, jaundice, newborn small for gestational age. Most of the infected mothers were 20-35 years old (81.8%); 60.6% were married; 63.6% underwent prenatal care; 48.5% reported previous spontaneous abortion, and 12.1% reported previous stillbirth. The rate of bisexuality among fathers was 9.1%. Conclusion: Syphilis control measures and prenatal care were not sufficient to prevent the high rate of the disease.

Methods

This study was conducted at the maternity ward of Fundação Santa Casa de Misericórdia do Pará, Brazil, from May to September 1996. We interviewed 361 mothers, and their newborns were physically examined. Serum samples from both mothers and neonates were tested with three methods: VDRL, FTA - Abs, and ELISA IgM. The diagnosis of congenital syphilis was established according to the criteria defined by the Brazilian Health Ministry in 1993. Results: The rate of congenital syphilis was 9.1% (33); 14 newborns had one or more signs of the disease: prematurity, hepatomegaly, stillbirth, splenomegaly, perinatal death, abdominal distention, nasal stuffiness, jaundice, newborn small for gestational age. Most of the infected mothers were 20-35 years old (81.8%); 60.6% were married; 63.6% underwent prenatal care; 48.5% reported previous spontaneous abortion, and 12.1% reported previous stillbirth. The rate of bisexuality among fathers was 9.1%. Conclusion: Syphilis control measures and prenatal care were not sufficient to prevent the high rate of the disease.

Results

The rate of congenital syphilis was 9.1% (33); 14 newborns had one or more signs of the disease: prematurity, hepatomegaly, stillbirth, splenomegaly, perinatal death, abdominal distention, nasal stuffiness, jaundice, newborn small for gestational age. Most of the infected mothers were 20-35 years old (81.8%); 60.6% were married; 63.6% underwent prenatal care; 48.5% reported previous spontaneous abortion, and 12.1% reported previous stillbirth. The rate of bisexuality among fathers was 9.1%. Conclusion: Syphilis control measures and prenatal care were not sufficient to prevent the high rate of the disease.

Conclusion

Syphilis control measures and prenatal care were not sufficient to prevent the high rate of the disease.

Resumen

Objetivo

Verificar a incidência de sífilis congênita em neonatos, em maternidade de hospital público.

Métodos

A pesquisa foi realizada na maternidade do Hospital Fundação Santa Casa de Misericórdia do Pará, no período de maio a setembro de 1996. Foram entrevistadas 361 puérperas e realizados os exames físicos de seus recém-nascidos. Ambos foram submetidos a 3 exames sorológicos: VDRL, FTA - Abs, ELISA IgM. Para o diagnóstico de sífilis congênita, empregaram-se os critérios indicados pelo Ministério da Saúde em 1993.

Resultados

A incidência de sífilis congênita foi de 9,1% (33); em 14 casos, houve um ou mais sinais indicativos da doença: prematuridade, hepatomegalia, natimortalidade, esplenomegalia, neomortalidade, distensão abdominal, obstrução nasal, icterícia, recém-nascido pequeno para a idade gestacional. A maioria das mães com sífilis estava na faixa de 20 a 35 anos de idade (81,8%); 60,6% eram casadas; 63,6% haviam realizado o pré-natal; 48,5% referiram abortos espontâneos e 12,1% episódios de natimortalidade, em gestações anteriores; 12,1% confessaram consumir drogas. Bissexualidade paterna foi registrada em 9,1% dos casos.

Conclusão

Os programas de controle da sífilis e os cuidados pré-natais não estão conseguindo prevenir a incidência expressiva da moléstia.