Subsequent pregnancies in women with previous gestational syphilis.
This study included data on syphilis-positive pregnant women seen for delivery or miscarriage, between 1997 and 2004, in Sao Lucas Hospital, Porto Alegre, RS. Their subsequent obstetric outcomes were studied, until December 2011, to see if the disease recurred. From 450 pregnant women with positive syphilis serology, seen from 1997 to 2004, 166 had at least one more obstetric attendance until December 2011, with 266 new obstetric outcomes. Congenital syphilis (CS) was demonstrated in 81.9% of the initial pregnancies and in 68.4% of the subsequent ones. The main causes of CS in subsequent pregnancies were a negative VDRL that turned positive at delivery, and undocumented treatment. VDRL titers were higher than 1:4 in 50.4% of the initial and 13.3% of the subsequent pregnancies (p < 0.01). Perinatal mortality rate was 119/1000 in initial and 41/1000 in subsequent pregnancies (p < 0.01). CS recurrence was frequent in subsequent pregnancies of women who tested positive for syphilis in a preceding pregnancy. No or inadequate prenatal care was the main risk factor for CS, both in initial and in subsequent pregnancies. These data suggest that non-infected neonates could have been defined as CS cases because of insufficient information about the mother's history.
Departamento de Pediatria, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, BR, jogarlow@terra.com.br.
Marjorie Garlow
MG
Hebmuller
Departamento de Pediatria, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, BR, jogarlow@terra.com.br.
Humberto Holmer
HH
Fiori
Departamento de Pediatria, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, BR, jogarlow@terra.com.br.
Eleonor Gastal
EG
Lago
D000022:Abortion, Spontaneous; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011295:Prenatal Care; D012307:Risk Factors; D013587:Syphilis; D013588:Syphilis Serodiagnosis / Q000009:adverse effects; D013590:Syphilis, Congenital / Q000453:epidemiology* / Q000209:etiology