Gestational syphilis: association between prenatal guidance, maternal serological evolution and vertical transmission

To verify the association between prenatal guidance and serological progression in postpartum women with gestational syphilis and syphilis test reactivity in newborns.

A cross-sectional study conducted at a university hospital from November 2023 to August 2024. The sample consisted of 119 postpartum women diagnosed with syphilis during prenatal care, and who received adequate treatment or not. Data were collected using a questionnaire administered to postpartum women and medical records and analyzed using Pearson's chi-square test.

Postpartum women had adequate responses to the guidance received during prenatal care: definition of syphilis (59.7%), transmission (84.9%), treatment (94.1%), maternal/fetal consequences (59.7%), prevention (74.8%), vertical transmission (31.1%), congenital syphilis (53.8%), and diagnostic tests (63.9%). A positive association was found between adequate responses to diagnostic tests and proper treatment (p=0.035). Between adequate responses regarding treatment and maintenance or increase in Venereal Disease Research Laboratory (VDRL) titers (p=0.030), and between adequate responses regarding vertical transmission (p=0.034) and diagnostic tests (p=0.039) with VDRL-reactive newborns at birth. Regarding sexual partners, 52.1% had no record of treatment.

Despite the adequate responses of most postpartum women to prenatal guidance, maintenance, or an increase in maternal VDRL titers and neonatal reactivity, these findings suggest gaps in educational actions and failure in the treatment of sexual partners.