Avaliação do perfil sociodemográfico, clínico-epidemiológico e distribuição espaço-temporal da sífilis em gestantes atendidas em uma maternidade pública no estado de São Paulo

Abstract

Syphilis is a major public health problem in Brazil and worldwide, despite effective measures for diagnosis, treatment, prevention, and control. Untreated syphilis in pregnant women can lead to fetal infection, potentially resulting in stillbirths or neonatal deaths. Social, political, economic, and individual factors can hinder access to care, especially for more vulnerable populations, contributing to the continued prevalence of new cases. This study evaluates the sociodemographic, clinical-epidemiological profile and the spatiotemporal distribution of cases of syphilis in pregnant women and congenital syphilis, treated at a public hospital in the State of São Paulo, from January 2019 to December 2023. This is a cross-sectional, quantitative and retrospective analytical study, where we analyzed data from pregnant women with syphilis and their newborns, 251 with congenital syphilis and 429 exposed to syphilis. The pandemic did not affect the progression of the disease in our region. However, the actions of the Vertical Transmission Investigation Committee suggest an impact on its progression, with stable reported cases and an increase in the number of pregnant women notified and adequately treated. The variables race/color, marital status, and education demonstrate statistically significant differences between the groups of newborns with syphilis and those exposed to Treponema pallidum, as well as timing of maternal diagnosis and treatment. Most newborns with syphilis were asymptomatic; however, we recorded 8% stillbirths and miscarriages. The spatial pattern shows locations where cases are concentrated, with syphilis cases more concentrated in specific areas, and those exposed to the disease more widespread and dispersed. We believe that understanding the locations with the highest concentration of cases, allowing for targeted actions at the local level, aligned with greater involvement of policymakers and seeking to support the consolidation of public policies addressing this issue, can be a valuable tool for reducing vertical transmission in our region.