Reactive treponemal and non-treponemal tests in pregnant women and associated factors

Reis, Amanda Ribeiro de Paula; Duarte, Geraldo; Menegueti, Mayra Gonçalves; Reis, Renata Karina; Silva, Ana Cláudia Rabelo e; Gir, Elucir

doi:10.1590/1980-220X-REEUSP-2022-0146en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 56 • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2022-0146en copy

Reactive treponemal and non-treponemal tests in pregnant women and associated factors^* * Extracted from the master’s thesis: “Testes treponêmicos e não treponêmicos reagentes e não reagentes em gestantes e os fatores associados”, Escola de Enfermagem de Ribeirão Preto at Universidade de São Paulo, 2022.

Pruebas treponémicas y no treponémicas reactivas en mujeres embarazadas y factores asociados

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to identify the rate of reactive treponemal and non-treponemal tests in pregnant women during childbirth and to analyze the factors associated with this seroreactivity.

Method:

this is a cross-sectional, quantitative study with secondary sources of sociodemographic and clinical data on 2,626 pregnant women treated at a public maternity hospital in the interior of São Paulo, in 2020. For statistical analysis, Fisher’s exact test, Mann-Whitney test and the logistic regression model were used. A difference of p < 0.05 was considered statistically significant.

Results:

the rate of seropositivity for syphilis among pregnant women in this series was 2.74%. Among the groups with positive and non-reactive tests, marital status, occupation, place of residence and use of licit drugs indicated significant differences, but, in the final model, only unmarried marital status was associated with reactive tests (Odds Ratio: 0.169; Confidence Interval: 0.04–0.72; and p: 0.016).

Conclusion:

in this study, unmarried marital status was the only independent factor associated with seroreactivity for syphilis. Therefore, it is necessary to create strategies aimed at women in this condition, potentially reducing the rate of congenital syphilis.

DESCRIPTORS
Syphilis; Pregnancy; Prenatal Care; Serologic Tests; Causality

Pregnant woman group	Non-reactive TT* (n = 2,554)			Reactive TT and NTT (n = 72)			p-value*
Quantitative variables	Median	Minimum value	Maximum value	Median	Minimum value	Maximum value	p-value*
Maternal age	25	13	47	23	14	39	0.06
Number of pregnancies	2	1	7	3	1	7	0.32
Number of births	1	0	6	1	0	5	0.28
Number of miscarriages	1	1	5	1	1	3	0.29
Number of prenatal consultations	9	2	10	9	2	10	0.41

Pregnant woman group	Non-reactive TT*		Reactive TT and NTT		Total		p-value*
Qualitative variables	nº	(%)	nº	(%)	nº	(%)	p-value*
Race
White	1504	97.66	36	2.34	1540	100	0.146
Non-white	1050	96.69	36	3.31	1086	100	0.146
Marital status
Unmarried	1959	96.60	69	3.40	2028	100	0.000
Married	594	99.50	3	0.50	597	100
Not recorded	1	100	0	0.00	1	100
Occupation
No formal job	1433	96.50	52	3.50	1485	100	0.019
With formal job	987	98.11	19	1.89	1006	100
Not recorded	134	99.26	1	0.74	135	100
Residence
Ribeirão Preto	1314	96.48	48	3.52	1362	100	0.012
Other municipalities	1240	98.10	24	1.90	1264	100	0.012
Educational level
Incomplete elementary school	531	94.99	28	5.01	559	100	0.002
Complete elementary school	246	96.85	8	3.15	254	100
Incomplete high school	546	96.81	18	3.19	564	100
Complete high school	1096	98.38	18	1.62	1114	100
Complete higher education	118	100	0	0.00	118	100
Graduate education	5	100	0	0.00	5	100
Not recorded	12	100	0	0.00	12	100
Licit drug use
No	1468	97.80	33	2.20	1501	100	0.035
Yes	201	95.26	10	4.74	211	100
Not recorded	885	96.80	29	3.20	914	100
Illicit drug use
Yes	36	94.74	2	5.26	38	100	–
Not recorded	2518	97.30	70	2.70	2588	100	–
Pregnancy outcome
Live births	2535	97.31	70	2.69	2605	100	0.311
Stillbirth	19	90.48	2	9.52	21	100	0.311

Predictor variables/parameters	Odds Ratio (OR)	Standard error	Confidence Interval (95% CI)	p-value*
Maternal age	0.988	0.037	(0.93 – 1.05)	0.716
Number of births	1.051	0.158	(0.78 – 1.41)	0.736
Number of miscarriages	1.421	0.373	(0.85 – 2.38)	0.181
Categorized race	1.472	0.467	(0.79 – 2.74)	0.222
Categorized marital status	0.169	0.125	(0.04 – 0.72)	0.016
Categorized occupation	0.890	0.305	(0.45 – 1.75)	0.734
Categorized residence	0.597	0.194	(0.32 – 1.13)	0.113
Educational level	0.859	0.109	(0.01 – 2.96)	0.232
Categorized licit drug use	1.583	0.613	(0.74 – 3.38)	0.235

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Amanda Ribeiro de Paula Reis Avenida dos Bandeirantes 3900, Vila Monte Alegre 14040-902 – Ribeirão Preto, SP, Brazil amandarpr@gmail.com