Dataset Information

High Prevalence of Syphilis and Inadequate Prenatal Care in Brazilian Pregnant Women: A Cross-Sectional Study.

ABSTRACT: In Brazil, the reported number of syphilis cases among pregnant women has markedly increased. We conducted a cross-sectional study to determine the prevalence of Treponema pallidum infection and associated factors in pregnant women in Dourados, Mato Grosso do Sul, Brazil. Participants voluntarily completed a risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for the presence of antibodies against T. pallidum, the causative agent of syphilis. Data of newborns were obtained from medical records. We performed univariate and multivariate regression analyses to assess associations with syphilis. The seroprevalence of syphilis in pregnant women was 4.4% (n = 29/661). Twenty-five newborns were seropositive for T. pallidum, and complications due to syphilis were observed in 28% (n = 7/25). Although 96.5% (n = 28/29) of women with syphilis received antenatal care, Venereal Disease Research Laboratory tests were performed in the first trimester for 47.6% (n = 10/21) of women. Women who received treatment in the third trimester (28.6%; n = 6/21) were considered successfully treated at the time of delivery. The use of illicit drugs during pregnancy (odds ratio [OR]: 13.3, 95% CI: 1.9-91.2) and a history of abortion (OR: 3.7, 95% CI: 1.7-8) were associated with syphilis. Our findings highlight that the poor quality of antenatal care services contributes to the high prevalence of syphilis. In addition, there are social and behavioral risk factors associated with syphilis in pregnant women. Future studies are needed to determine limitations of clinical management and control services available to pregnant women with syphilis.

SUBMITTER: Benedetti KCSV

PROVIDER: S-EPMC6779194 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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High Prevalence of Syphilis and Inadequate Prenatal Care in Brazilian Pregnant Women: A Cross-Sectional Study.

Benedetti Kelle Cristhiane Soria Vieira KCSV Ribeiro Anny Danyelly da Costa ADDC Queiroz Júlio Henrique Ferreira de Sá JHFS Melo Amanda Barbosa Dias ABD Batista Roque Beltrão RB Delgado Flavia Maria FM da Silva Kesia Esther KE Croda Júlio J Simionatto Simone S

The American journal of tropical medicine and hygiene 20191001 4

In Brazil, the reported number of syphilis cases among pregnant women has markedly increased. We conducted a cross-sectional study to determine the prevalence of <i>Treponema pallidum</i> infection and associated factors in pregnant women in Dourados, Mato Grosso do Sul, Brazil. Participants voluntarily completed a risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for the presence of antibodies against <i>T. pallidum</i>, the causative agent of syphilis. Data ...[more]

PMID: 31407659

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Project description:BACKGROUND:Alcohol consumption during pregnancy is associated with adverse pregnancy outcomes such as preventable alcohol-related developmental disability fetal alcohol syndrome. In Zambia, alcohol use and associated risk factors have not been investigated, and screening in prenatal care is nonexistent. This study determined individual correlates and the prevalence of alcohol use in pregnant women attending prenatal care at two health clinics in Lusaka, Zambia. METHODS:A study adopted a cross-sectional design and recruited 188 pregnant women after seeking their informed consent from July 19 to 31, 2017. Participants aged 18 or over completed the T-ACE (Tolerance, Annoyance, Cut Down and Eye Opener) screening tool and validated alcohol-screening questionnaires on self-reported alcohol use periconceptional and during conception period while at their regular prenatal visit. The T-ACE screening tool assessed the risk of alcohol dependence in four short questions. The questionnaires included demographic questions. Bivariate analyses were performed using the ?2 test for dichotomous variables and the t-test for continuous variables. Mixed-effects linear models were used to evaluate the effect of outcome variables with patient-level variables. RESULTS:About 40 (21.2%) pregnant women were identified by the T-ACE as at-risk for problem drinking during pregnancy. Except for regular prenatal care and distance, there was no difference in the demographic factors between pregnant women who scored <?2 on the T-ACE and those that scored >?2 points (all p's?>?0.05). A small proportional of women at both clinics reported binge drinking during the periconceptional period (12.7% vs. 3.2%, p?=?0.003) and beyond periconception period. Excluding employed women, no significant relationships were observed between alcohol use and demographic factors. CONCLUSION:Alcohol consumption is prevalent in the periconceptional period and during pregnancy in pregnant women attending prenatal care in Zambia. Findings underscore the need for targeted alcohol use screening and intervention for pregnant women.

Project description:Antibiotic use in pregnant women at the national level has rarely been reported in China. We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper--Pearson method or Goodman method. Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0-2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7-5.0%), whereas that for pregnant women aged 26-30 years was 1.5% (95% CI, 1.4-1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3-5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4-0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0-60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1-3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2-17.4%) were not assigned any FDA pregnancy category. Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

Project description:ObjectiveSyphilis is one of the most imperative STIs, caused by the spirochete Treponema pallidum. During pregnancy it is associated with disastrous health outcomes in the newborn. In sub-Saharan Africa, study findings on the prevalence of syphilis among pregnant women are highly dispersed and inconsistent. The aim of the current review is to conduct a systematic review and meta-analysis of syphilis in sub-Saharan Africa among pregnant women.DesignSystematic review and meta-analysis.Data sourcesDatabases including MEDLINE, PubMed, Cochrane Library, Google Scholar, and HINARI and reference lists of previous prevalence studies were systematically searched for relevant literature from January 1999 to November 2018. Results were presented in forest plot, tables, and figures. Random-effects model was used for the meta-analysis. For the purpose of this review, a case of syphilis was defined as positive treponemal or nontreponemal tests among pregnant women.Data extractionOur search gave a total of 262 citations from all searched databases. Of these, 44 studies fulfilling the inclusion criteria and comprising 175,546 subjects were finally included.ResultsThe pooled prevalence of syphilis among pregnant women in sub-Saharan Africa was 2.9% (95%CI: 2.4%-3.4%). East and Southern African regions had a higher syphilis prevalence among pregnant women (3.2%, 95% CI: 2.3%-4.2% and 3.6%, 95%CI: 2.0%-5.1%, respectively) than the sub-Saharan African pooled prevalence. The prevalence of syphilis among pregnant women in most parts of the region seemed to have decreased over the past 20 years except for the East African region. However, prevalence did not significantly differ by region and time period.ConclusionThis review showed a high prevalence of syphilis in sub-Saharan Africa among pregnant women. The evidence suggests strengthening the screening program during pregnancy as part of the care package during antenatal care visits. Programs focusing on primary prevention of syphilis in women should also be strengthened.

Project description:Background:Sleep problems in late pregnancy are common, but sleep in early pregnancy is less well described. The aim of this study was to describe the occurrence and severity of sleep complaints in early pregnancy. We asked the women about worries due to sleep problems. Furthermore, we investigated the associations between sleep complaints and pregnancy-related symptoms. This association was studied taking into account physical and mental health, sociodemographic characteristics, and reproductive history of the women.Methods:Cross-sectional study in Danish general practice based on an electronic questionnaire completed by pregnant women and a Pregnancy Health Record filled in by the general practitioner (GP). The questionnaire measured three sleep complaints and 11 common physical pregnancy-related symptoms. The sleep complaints were measured as mild, moderate or severe, and it was recorded how much they worried the women. The associations between the physical pregnancy-related symptoms and sleep complaints were assessed by odds ratios from multivariable logistic regression models.Results:The questionnaire was completed by 1338 out of 1508 eligible women before the end of gestation week 16. The gestational age ranged from 5 to 16?weeks (median 11?weeks) among the included women. On average, more than one third of the women reported to have at least one of the three sleep complaints in the questionnaire. Problems "taking a long time to fall asleep" was reported by 312 women (23%), "waking up too early" was reported by 629 (47%), and 183 (14%) had been "lying awake most of the night". One sleep complaint was reported by 38%, two by 16, and 4% had all three symptoms. The majority were not at all or only mildly worried because of their sleep disturbances, but moderate or severe worries were found among 46% of those" taking a long time to fall asleep" and among 40% of those "lying awake most of the night". "Moderate or severe complaints" were reported by 277 (21%) women "Moderate or severe complaints" were associated with pregnancy-related physical symptoms, such as back pain, pelvic girdle pain and pelvic cavity pain, but only the association with pelvic cavity pain stayed significant after adjustment for depression.Conclusion:This study showed that sleep complaints in early pregnancy are common, and sleep complaints showed association with physical as well as mental symptoms. It may be important for pregnant patients that clinicians address depression, and mood in relation to sleep problems during pregnancy.

Dataset Information

High Prevalence of Syphilis and Inadequate Prenatal Care in Brazilian Pregnant Women: A Cross-Sectional Study.

Publications

High Prevalence of Syphilis and Inadequate Prenatal Care in Brazilian Pregnant Women: A Cross-Sectional Study.

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