Syphilis in parturient women in Brazil: prevalence and associated factors, 2010 to 2011

Objective. To estimate the prevalence and investigate the factors associated with syphilis in parturient women in Brazil. Method. This nationwide cross-sectional population-based study, with regional representativeness, was carried out with parturient women aged 15 to 49 years delivering babies in public healthcare system/partner maternity facilities between January 2010 and December 2011. Syphilis screening was based on a rapid treponemal test. Diagnostic confirmation was based on the Venereal Disease Research Laboratory (VDRL) test and additional treponemal tests. A structured questionnaire was used for collection of clinical and sociodemographic variables. Information regarding pre-natal consultations was obtained from the prenatal card and medical records. The association between the variables of interest and syphilis was investigated using odds ratios and logistic regression. Results. Information was obtained from 36 713 women. The overall prevalence of syphilis for the country was 0.89%; the prevalence in the North, Northeast, Southeast, South, and Mid-West regions was 1.05%, 1.14%, 0.73%, 0.48%, and 1.20% respectively. Seropositive results were associated with absence of prenatal consultations, fewer prenatal consultations, and late start of prenatal consultations. Of the women diagnosed during prenatal consultations, 53.1% were still infected at delivery. Increased risk of syphilis was observed in women of yellow, black, and brown race/skin color as well as in those with fewer years of schooling than in women of white race/skin color and more years of schooling. Conclusions. A reduction in the prevalence of syphilis in Brazil was recorded. However, this disease is still associated with social and regional inequality.