Fatores associados com ocorrência de sífilis congênita: revisão sistemática da literatura

Abstract

Title: Factors associated with occurrence of congenital syphilis: a systematic review Background: Congenital syphilis (CS) is a disease with significant morbidity and mortality in Brazil and worldwide. Soon as possible identification in pregnant women is critical to reduce the risk of transmission to fetus. In this respect, prenatal becomes the most important factor intervention. Considering importance of this issue in public health, identification of risk factors for SC are key to achieving public policy in this disease reduction order in addition to providing guidance for health professionals to identify it. The aim of this study is to review the risk factors for SC. Methods:systematic review according to the PRISMA guidelines. Study population was live newborns diagnosed with SC by serological methods and/or PCR. Risk factors associated with vertical transmission of T. pallidum were searched. Articles should be available for full access by CAPES network in Portuguese, English or Spanish. There was not publication date limit. Stillbirths were excluded. Search was conducted in MEDLINE using the keywords "congenital syphilis", "risk factors","etiology"and "associated factors" for title and abstract. Search was complemented in Biblioteca Virtual de Saúde (BVS). Results: 96 studies were identified in MEDLINE and 870 documents in BVS with15 articles and total of 3,288 cases of CS. Several factors were evaluated among the studies for occurrence of SC. Those who were strongly associated, were the lack of prenatal care, inappropriate treatment, primary syphilis, treatment in the third quarter and cocaine use by pregnant women. Black ethnicity, age less than 20 years, being single, being unemployed, and low educational level were variables that showed associations between studies. Alcohol and tobacco use were associated in univariate analyzes in some studies, but with different results after adjustment for confounders. Other factors such as number of partners, and greater treponemic titles (1:8) were associated with SC, but were evaluated in a few studies. Conclusions: lack of prenatal care is the most important and consistent risk factor for SC. Other important factors are the absence of treatment, primary syphilis and late treatment (3rd quarter). Cocaine use, black ethnicity, being unemployed, being single, teen and low educational level should be seen as risk populations for SC.