Clinical and socioeconomic determinants of congenital syphilis in Posadas, Argentina.
OBJECTIVE
To explore clinical and socioeconomic factors related to congenital syphilis in Posadas, Argentina.


METHODS
Data were collected from 102 mothers who had given birth to an infant with congenital syphilis at Dr. Ramón Madariaga Central Hospital (2005-2007) and 306 control mothers. Clinical and demographic information were collected from clinical records, and socioeconomic details were obtained by interview. Multivariable logistic regression was used to explore the relationships between congenital syphilis and clinical and socioeconomic factors.


RESULTS
Receiving the recommended number of prenatal health checks had a clear protective effect on congenital syphilis in the univariate analysis (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.31-0.86), as did being in a stable relationship (OR 0.23, 95% CI 0.14-0.38). Furthermore, women with secondary education or above were over four-times less likely to have a child with congenital syphilis compared to women who had not completed primary school education, even after controlling for the number of prenatal health checks and other factors (adjusted OR 0.24, 95% CI 0.08-0.72). In addition, women with previous stillborn births were over three-times more likely to have a baby with congenital syphilis after controlling for education and prenatal care (adjusted OR 3.37, 95% CI 1.24-9.16).


CONCLUSIONS
There is a clear opportunity for reducing the burden of congenital syphilis by promoting syphilis screening and treatment in women with previous stillborn births. In addition, the potential impact of more general policies addressing social determinants of health, such as those improving education, must not be overlooked.
Department of Public Health, Universidad Miguel Hernandez de Elche, Campus de San Juan, Ctra. Alicante-Valencia, Km. 8'7, Alicante 03550, Spain. lparker@umh.es
Lucy Anne
LA
Parker
Enrique Jorge
EJ
Deschutter
Fernando Jorge
FJ
Bornay-Llinares
Ildefonso
I
Hernandez-Aguado
Gustavo
G
Silva
Rosa Del Carmen
Rdel C
Piragine
Blanca
B
Lumbreras
D000293:Adolescent; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D016022:Case-Control Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015999:Multivariate Analysis; D011203:Poverty; D012044:Regression Analysis; D013590:Syphilis, Congenital / Q000453:epidemiology*; D014505:Urban Population; D055815:Young Adult