ArticleJornal de pediatria
Adherence to the treatment of gestational syphilis: influence of psychosocial, socioeconomic, and clinical factors.
Article in Jornal de pediatria. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo identify psychosocial, sociodemographic, and clinical factors associated with adherence to gestational syphilis treatment.
methodcross-sectional study with a sample of 325 pregnant women diagnosed with syphilis during pregnancy. The main outcome was complete adherence to the therapeutic regimen of three doses of penicillin, including the partner's treatment. Data were collected through structured interviews and medical records. Statistical analysis included logistic regressions and co-occurrence network analysis to explore interrelationships between factors associated with treatment adherence.
resultsTreatment adherence was observed in 43.6% of pregnant women and their partners. Newborns of mothers who adhered to treatment had significantly higher Apgar and Capurro scores. Positive factors associated with adherence included early diagnosis in the first trimester (odds ratio [OR]: 5.12, 95% confidence intervals [CI]: 2.8-9.7), adequate prenatal follow-up (OR: 4.37, CI: 2.5-7.7), planned pregnancy (OR: 2.36, CI: 1.3-4.1), employment (OR: 1.72, CI: 1.1-2.7), and income above the minimum wage (OR: 1.71, CI: 1.1-2.6). Negative factors included a history of substance misuse during life and pregnancy (OR: 0.34, CI: 0.1-0.7), childhood maltreatment (OR: 0.53, CI: 0.3-0.8), recurrent unprotected sex (OR: 0.61, CI: 0.3-0.9), marital conflicts (OR: 0.47, CI: 0.3-0.7), witnessed violence (OR: 0.51, CI: 0.3-0.8), and prior police detention (OR: 0.29, CI: 0.1-0.5). Network analysis revealed three clusters related to these factors: one associated with violence, another with substance use, and another involving socioeconomic factors and prenatal care access.
conclusionAdverse maternal psychosocial factors, such as violence, maltreatment, and substance use, hamper treatment adherence and may contribute to worse neonatal outcomes.
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