Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in Lisbon
Introduction: Congenital syphilis is a preventable disease and its persistence reflects a failure in prenatal care delivery systems. Objectives: To identify demographic maternal characteristics, risk factors and clinical features of congenital syphilis. The secondary outcome was to describe the sy...
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| Format: | Article |
| Language: | English |
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Hygeia Press di Corridori Marinella
2019-03-01
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| Series: | Journal of Pediatric and Neonatal Individualized Medicine |
| Subjects: | |
| Online Access: | https://www.jpnim.com/index.php/jpnim/article/view/587 |
| _version_ | 1818259054356594688 |
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| author | Francisca Costa Maria Mendes Marta Ferreira Rosalina Barroso |
| author_facet | Francisca Costa Maria Mendes Marta Ferreira Rosalina Barroso |
| author_sort | Francisca Costa |
| collection | DOAJ |
| description | Introduction: Congenital syphilis is a preventable disease and its persistence reflects a failure in prenatal care delivery systems.
Objectives: To identify demographic maternal characteristics, risk factors and clinical features of congenital syphilis. The secondary outcome was to describe the symptomatic cases of congenital syphilis.
Methods: Retrospective study of all the children born, between 1997-2015, to syphilis seropositive women. We collected data regarding sociodemographic characteristics, maternal VDRL (Venereal Disease Research Laboratory) titers, co-infections and treatment during pregnancy, clinical features, treatment and follow-up.
Results: From a total of 80,639 newborns, 310 mothers and 225 babies had positive VDRL titers. The prevalence risk for congenital syphilis was 0.27%, higher between 2003-2008. Observed maternal characteristics were: 3.9% young mothers (< 20 y), 45.2% African origin, 12.5% basic educational levels, 14.5% unemployed, 6.5% co-infected with human immunodeficiency virus (HIV), 4.7% drug abuse. Prenatal care coverage was provided in 82.9% of the mothers, with only 52.9% adequately treated. Maternal syphilis was classified in: 21.6% early, 21.6% late, 56.8% undetermined. The newborns were classified in: 13.2% highly probable, 41.6% possible and 45.2% less likely. There were four cases of symptomatic congenital syphilis, 3 of them with neurosyphilis. 96% were treated with penicillin. 165/310 (53%) had an adequate follow-up, and the mean age for a negative VDRL titer was at 5.6 months of age.
Conclusions: The high percentage of women inadequately treated alerts to the importance of improving prenatal care. Neurosyphilis is a rare and severe presentation of congenital syphilis; screening is essential to avoid late cases or sequels. |
| first_indexed | 2024-12-12T18:09:20Z |
| format | Article |
| id | doaj.art-04631b43386e4dcf91911395603582d3 |
| institution | Directory Open Access Journal |
| issn | 2281-0692 |
| language | English |
| last_indexed | 2024-12-12T18:09:20Z |
| publishDate | 2019-03-01 |
| publisher | Hygeia Press di Corridori Marinella |
| record_format | Article |
| series | Journal of Pediatric and Neonatal Individualized Medicine |
| spelling | doaj.art-04631b43386e4dcf91911395603582d32022-12-22T00:16:25ZengHygeia Press di Corridori MarinellaJournal of Pediatric and Neonatal Individualized Medicine2281-06922019-03-0181e080119e08011910.7363/080119494Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in LisbonFrancisca Costa0Maria Mendes1Marta Ferreira2Rosalina Barroso3Hospital Professor Doutor Fernando da Fonseca, EPE. Lisbon, PortugalHospital Professor Doutor Fernando da Fonseca, EPE. Lisbon, PortugalHospital Professor Doutor Fernando da Fonseca, EPE. Lisbon, PortugalHospital Professor Doutor Fernando da Fonseca, EPE. Lisbon, PortugalIntroduction: Congenital syphilis is a preventable disease and its persistence reflects a failure in prenatal care delivery systems. Objectives: To identify demographic maternal characteristics, risk factors and clinical features of congenital syphilis. The secondary outcome was to describe the symptomatic cases of congenital syphilis. Methods: Retrospective study of all the children born, between 1997-2015, to syphilis seropositive women. We collected data regarding sociodemographic characteristics, maternal VDRL (Venereal Disease Research Laboratory) titers, co-infections and treatment during pregnancy, clinical features, treatment and follow-up. Results: From a total of 80,639 newborns, 310 mothers and 225 babies had positive VDRL titers. The prevalence risk for congenital syphilis was 0.27%, higher between 2003-2008. Observed maternal characteristics were: 3.9% young mothers (< 20 y), 45.2% African origin, 12.5% basic educational levels, 14.5% unemployed, 6.5% co-infected with human immunodeficiency virus (HIV), 4.7% drug abuse. Prenatal care coverage was provided in 82.9% of the mothers, with only 52.9% adequately treated. Maternal syphilis was classified in: 21.6% early, 21.6% late, 56.8% undetermined. The newborns were classified in: 13.2% highly probable, 41.6% possible and 45.2% less likely. There were four cases of symptomatic congenital syphilis, 3 of them with neurosyphilis. 96% were treated with penicillin. 165/310 (53%) had an adequate follow-up, and the mean age for a negative VDRL titer was at 5.6 months of age. Conclusions: The high percentage of women inadequately treated alerts to the importance of improving prenatal care. Neurosyphilis is a rare and severe presentation of congenital syphilis; screening is essential to avoid late cases or sequels.https://www.jpnim.com/index.php/jpnim/article/view/587epidemiologydiagnostic testingcongenital syphilisneurosyphiliscomplications |
| spellingShingle | Francisca Costa Maria Mendes Marta Ferreira Rosalina Barroso Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in Lisbon Journal of Pediatric and Neonatal Individualized Medicine epidemiology diagnostic testing congenital syphilis neurosyphilis complications |
| title | Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in Lisbon |
| title_full | Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in Lisbon |
| title_fullStr | Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in Lisbon |
| title_full_unstemmed | Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in Lisbon |
| title_short | Congenital syphilis: a revision of the cases over the last 18 years in a referral hospital in Lisbon |
| title_sort | congenital syphilis a revision of the cases over the last 18 years in a referral hospital in lisbon |
| topic | epidemiology diagnostic testing congenital syphilis neurosyphilis complications |
| url | https://www.jpnim.com/index.php/jpnim/article/view/587 |
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