Abstract：
OBJECTIVE: The present study aimed to evaluate the association between syphilis in pregnancy and low birth weight, small for gestational age, and preterm birth.
METHODS: This longitudinal study used Brazilian National Information System for livebirths (SINASC) linked to the gestational syphilis cases from Notifiable Diseases Information System (SINAN) from 2011 to 2017. Descriptive statistics and logistic regression were used to compare the birth outcomes of pregnant women with and without syphilis. The study protocol was approved by the Research Ethics Committee of the Institute of Collective Health of the Federal University of Bahia (CAAE: registration no. 18022319.4.0000.5030).
RESULTS: A total of 17 930 817 live births were included in the study. Of these, 155 214 (8.7/1000) were exposed to syphilis during pregnancy. Maternal syphilis increased the odds of low birth weight (aOR 1.88, 95% CI: 1.85-1.91), small for gestational age (aOR 1.53, 95% CI: 1.51-1.56), and preterm birth (aOR 1.35, 95% CI: 1.33-1.37). Higher odds were observed for pregnant women with VDRL titer ≥64 and untreated maternal syphilis when compared to mothers without syphilis. Analysis stratified by prenatal care showed higher odds for all adverse birth outcomes for mothers attending ≤6 prenatal appointments.
CONCLUSIONS: Our findings showed a strong association between gestational syphilis and adverse birth outcomes with increased odds observed among women with higher VDRL titers, lack of treatment, and fewer prenatal appointments. These results highlight the need for adequate screening and treatment for gestational syphilis during pregnancy to mitigate the risk of adverse birth outcomes.
METHODS: This longitudinal study used Brazilian National Information System for livebirths (SINASC) linked to the gestational syphilis cases from Notifiable Diseases Information System (SINAN) from 2011 to 2017. Descriptive statistics and logistic regression were used to compare the birth outcomes of pregnant women with and without syphilis. The study protocol was approved by the Research Ethics Committee of the Institute of Collective Health of the Federal University of Bahia (CAAE: registration no. 18022319.4.0000.5030).
RESULTS: A total of 17 930 817 live births were included in the study. Of these, 155 214 (8.7/1000) were exposed to syphilis during pregnancy. Maternal syphilis increased the odds of low birth weight (aOR 1.88, 95% CI: 1.85-1.91), small for gestational age (aOR 1.53, 95% CI: 1.51-1.56), and preterm birth (aOR 1.35, 95% CI: 1.33-1.37). Higher odds were observed for pregnant women with VDRL titer ≥64 and untreated maternal syphilis when compared to mothers without syphilis. Analysis stratified by prenatal care showed higher odds for all adverse birth outcomes for mothers attending ≤6 prenatal appointments.
CONCLUSIONS: Our findings showed a strong association between gestational syphilis and adverse birth outcomes with increased odds observed among women with higher VDRL titers, lack of treatment, and fewer prenatal appointments. These results highlight the need for adequate screening and treatment for gestational syphilis during pregnancy to mitigate the risk of adverse birth outcomes.
摘要：
目的：本研究旨在评估妊娠梅毒与低出生体重的关系。小于胎龄，和早产。
方法：这项纵向研究使用了巴西国家新生儿信息系统（SINASC），该系统与2011年至2017年来自应通报疾病信息系统（SINAN）的妊娠梅毒病例相关。使用描述性统计和逻辑回归比较有和没有梅毒的孕妇的出生结局。该研究方案得到了巴伊亚联邦大学集体健康研究所研究伦理委员会的批准（CAAE：注册号。18022319.4.0000.5030）。
结果：本研究共纳入17930817例活产。其中,怀孕期间有155214例（8.7/1000）暴露于梅毒。母亲梅毒增加了低出生体重的几率（aOR1.88，95％CI：1.85-1.91），小于胎龄（aOR1.53，95%CI：1.51-1.56），和早产（aOR1.35，95%CI：1.33-1.37）。与没有梅毒的母亲相比，VDRL滴度≥64且未经治疗的母亲梅毒的孕妇的几率更高。按产前护理分层的分析显示，对于接受≤6次产前预约的母亲，所有不良分娩结局的几率更高。
结论：我们的研究结果表明，妊娠梅毒与不良分娩结局之间存在很强的关联，在VDRL滴度较高的女性中观察到的几率增加，缺乏治疗,更少的产前预约。这些结果强调了在怀孕期间需要对妊娠梅毒进行充分的筛查和治疗，以减轻不良分娩结局的风险。
方法：这项纵向研究使用了巴西国家新生儿信息系统（SINASC），该系统与2011年至2017年来自应通报疾病信息系统（SINAN）的妊娠梅毒病例相关。使用描述性统计和逻辑回归比较有和没有梅毒的孕妇的出生结局。该研究方案得到了巴伊亚联邦大学集体健康研究所研究伦理委员会的批准（CAAE：注册号。18022319.4.0000.5030）。
结果：本研究共纳入17930817例活产。其中,怀孕期间有155214例（8.7/1000）暴露于梅毒。母亲梅毒增加了低出生体重的几率（aOR1.88，95％CI：1.85-1.91），小于胎龄（aOR1.53，95%CI：1.51-1.56），和早产（aOR1.35，95%CI：1.33-1.37）。与没有梅毒的母亲相比，VDRL滴度≥64且未经治疗的母亲梅毒的孕妇的几率更高。按产前护理分层的分析显示，对于接受≤6次产前预约的母亲，所有不良分娩结局的几率更高。
结论：我们的研究结果表明，妊娠梅毒与不良分娩结局之间存在很强的关联，在VDRL滴度较高的女性中观察到的几率增加，缺乏治疗,更少的产前预约。这些结果强调了在怀孕期间需要对妊娠梅毒进行充分的筛查和治疗，以减轻不良分娩结局的风险。
