Incidence of congenital syphilis in a metropolitan region of Rio de Janeiro state: social inequalities

ABSTRACT

Congenital syphilis remains a public health matter, with no perspective of reaching governmental reduction goals. There are few studies about social inequalities and its relation with this disease in Brazil. Objective: describe occurrence of congenital syphilis in a reference hospital in a Metropolitan Region of Rio de Janeiro State, according to socioeconomic and clinical-laboratorial variables as well. Methods: cross-sectional study, basedon interviews, review of medical records and prenatal cards. Population all women admitted to a maternity ward during a trimester in 2011. Maternal variables age, schooling, skin color, income, prenatal visits. Fetus/neonate variables birth weight, gestational age, clinical and laboratory outcomes.Incidence of congenital syphilis (Brazilian Ministry of Health criteria) was calculated for all live births and for each social and economical variable.Results: there were 666 eligible women, comprehending 576 deliveries ? 558 live births and 18 stillbirths. We identified 22 CS cases 18 live births, threefetal deaths and 1 abortion. One of the neonates died in the third day of life. The incidence of CS was of 39.4/1,000 live births. Socioeconomic variables - low education, low income and black skin - were related to a greater incidence. Only 13 out of 22 cases were identified in prenatal care. Conclusion: ourresults pointed to social inequalities in the congenital syphilis incidence. As prenatal care is also related to socioeconomic variables, investments in quality of maternal assistance should be directed to more vulnerable women.