title: Can the Perinatal Information System in Peru be used to measure the proportion of adverse birth outcomes attributable to maternal syphilis infection?
abstract: OBJECTIVE
  To describe the capacity of Peru's Perinatal Information System (Sistema Informático Perinatal, SIP) to provide estimates for monitoring the proportion of stillbirths and other adverse birth outcomes attributable to maternal syphilis.
  
  
  METHODS
  A descriptive study was conducted to assess the quality and completeness of SIP data from six Peruvian public hospitals that used the SIP continuously from 2000 - 2010 and had maternal syphilis prevalence of at least 0.5% during that period. In-depth interviews were conducted with Peruvian stakeholders about their experiences using the SIP.
  
  
  RESULTS
  Information was found on 123 575 births from 2000 - 2010 and syphilis test results were available for 99 840 births. Among those 99 840 births, there were 1 075 maternal syphilis infections (1.1%) and 619 stillbirths (0.62%). Among women with syphilis infection in pregnancy, 1.7% had a stillbirth, compared to 0.6% of women without syphilis infection. Much of the information needed to estimate the proportion of stillbirths attributable to maternal syphilis was available in the SIP, with the exception of syphilis treatment information, which was not collected. However, SIP data collection is complex and time-consuming for clinicians. Data were unlinked across hospitals and not routinely used or quality-checked. Despite these limitations, the SIP data examined were complete and valid; in 98% of records, information on whether or not the infant was stillborn was the same in both the SIP and clinical charts. Nearly 89% of women had the same syphilis test result in clinical charts and the SIP.
  
  
  CONCLUSIONS
  The large number of syphilis infections reported in Peru's SIP and the ability to link maternal characteristics to newborn outcomes make the system potentially useful for monitoring the proportion of stillbirths attributable to congenital syphilis in Peru. To ensure good data quality and sustainability of Peru's SIP, data collection should be simplified and information should be continually quality-checked and used for the benefit of participating facilities.
authors.affiliation: Division of STD Prevention, National Center for HIV/AIDS.
authors.forename: Heather
authors.initials: H
authors.lastname: Bradley
authors.affiliation: School of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Vilma
authors.initials: V
authors.lastname: Tapia
authors.affiliation: Division of STD Prevention, National Center for HIV/AIDS.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Kamb
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Newman
authors.affiliation: Epidemiology Unit, STI and HIV, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Garcia
authors.affiliation: Pan American Health Organization, Cen-tro Latinoamericano de Perinatología, Montevideo, Uruguay.
authors.forename: Suzanne J
authors.initials: SJ
authors.lastname: Serruya
authors.affiliation: IntraHealth International, Arlington, Virginia, United States of America.
authors.forename: Alfredo L
authors.initials: AL
authors.lastname: Fort
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Broutet
authors.affiliation: Division of STD Prevention, National Center for HIV/AIDS.
authors.forename: Robert
authors.initials: R
authors.lastname: Nelson
authors.affiliation: Division of STD Prevention, National Center for HIV/AIDS.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Kirkcaldy
authors.affiliation: School of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Gustavo F
authors.initials: GF
authors.lastname: Gonzales
mesh_terms: D005260:Female; D006751:Hospital Information Systems; D006801:Humans; D007231:Infant, Newborn; D010568:Peru / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D062486:Public Health Surveillance; D050497:Stillbirth / Q000453:epidemiology*; D013587:Syphilis; D013590:Syphilis, Congenital / Q000453:epidemiology*