Anthropometric and neurodevelopmental assessment of children with congenital syphilis: the influence of maternal treatment status during pregnancy

Avaliação antropométrica e do neurodesenvolvimento de crianças com sífilis congênita: a influência de status do tratamento materno na gestação

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Palavras-chave:

congenital syphilis, diet, growth, neurodevelopment

Resumo

Objective: To assess anthropometric evolution and neuropsychomotor development (DNPM) in children with congenital syphilis (CS). Method: A longitudinal and prospective study involving 66 mother/baby pairs, utilizing data from hospital discharge summaries, pregnancy cards, and quarterly outpatient follow-up appointments. Children who had not been followed up for 18 months, anoxic, premature or had a syndrome were excluded. Socioeconomic data, prenatal care, treatment, birth conditions, dietary history, anthropometric data and NPMD were collected. Results: A progressive deterioration in diet quality was observed, with 22.7% overweight/obesity, 22.4% at risk of DNPM delay, and 10.3% potentially delayed with statistical significance due to a diet rich in flour and simple carbohydrates, inadequate maternal treatment, and a higher number of children. Conclusion: Missed prenatal care opportunities and social vulnerability are related to the growth and DNPM of children with CS.

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Referências

BERG, J.M.; KIRMAN, J.H. Syphilis as a cause of mental deficiency. Br Med J., p. 400–404, 1959.

BRASIL. Ministério da Saúde. Boletim epidemiológico de sífilis. Número especial-out/2023. Brasília: Ministério da Saúde; 2023.

_______. Ministério da Saúde. Curvas de crescimento. (P/I, A/I, P/A, P/C, C/I, IMC). 2006. Disponível em: https://aps.saude.gov.br/ape/vigilanciaalimentar/curvascrescimento. Acesso em: 10 julho 2023.

_______. Ministério da Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Prevenção da Transmissão Vertical de HIV, Sífilis e Hepatites Virais. Brasília: Ministério da Saúde; 2022.

_______. Ministério da Saúde. Secretaria de Atenção Primaria à Saúde. Departamento de Promoção da Saúde. Guia alimentar para crianças brasileiras menores de 2 anos. Brasília: Ministério da Saúde, 2019. 265 p.

CDC. Centers for Disease Control and Prevention. Syphilis Treatment and Care, in 2015. STD. Treatment Guidelines - Syphilis. 2015. Disponível em: https://www.cdc.gov/std/syphilis/treatment.htm. Acesso em: 10 julho 2023.

FRANKENBURG, W.K. et al. DENVER II: training manual. 2nd ed. Denver, USA: Denver Developmental Materials; 1992.

HOLLANDERS, J.J. et al. Growth pattern and final height of very preterm vs. very low birth weight infants. Pediatric Research, vol. 82, p. 317–323, 2017.

KATTULA, D. et al. The first 1000 days of life: prenatal and postnatal risk factors for morbidity and growth in a birth cohort in southern India. Bmj Open, 2014.

KIMBALL, A. et al. Missed Opportunities for Prevention of Congenital Syphilis - United States, 2018. MMWR Morb Mortal Wkly Rep., Jun 05, vol. 69(22), p. 661-665, 2020.

KRUSKAL, W.H.; WALLIS, W. A. Use of Ranks in One-Criterion Variance Analysis. Journal of the American Statistical Association, v. 47, n. 260, p. 583–621, 1952.

LAGO, E.G.; VACCARI, A.; FIORI, R.M. Clinical features and follow-up of congenital syphilis. Sexually transmitted diseases, 2013. Disponível em: https://doi.org/10.1097/OLQ.0b013e31827bd688. Acesso em: 17 março 2023.

LUO, H. et al. Growth in syphilis-exposed and -unexposed uninfected children from birth to 18 months of age in China: a longitudinal study. Scientific reports, vol. 9(1), p. 4416, 2019. Disponível em: https://doi.org/10.1038/s41598-019-40134-3. Acesso em: 25 junho 2023.

MAGNUSON, H.J. et al. Inoculation syphilis in human volunteers. Medicine (Baltimore), v. 35(1), p. 33, 1956.

MALLARD, S.R. et al. Dietary diversity at 6 months of age is associated with subsequent growth and mediates the efect of maternal education on infant growth in urban Zambia. Journal of Nutrition, vol. 144.11, p. 1818, 2014.

MAXWELL, A.E. Comparing the classification of subjects by two independent judges. British Journal of Psychiatry, v. 116, p. 651–655, 1970.

PEELING, R.W. et al. Syphilis. Nature Reviews Disease Primers. v. 3 17073, 2017 Oct 12.

SHAPIRO, S. S.; WILK, M.B. An Analysis of Variance Test for Normality (Complete Samples). Biometrika, v. 52, n. 3/4, p. 591–611, 1965.

SIEGEL, S.; CASTELLAN JR, J. Estatística não-paramétrica para ciências do comportamento. 2. ed. Porto Alegre: Artmed Editora Ltda, 2006.

STOKES, J.H.B.; INGRAHAM, N.R. Sifilologia Clínica Moderna: Diagnóstico, Tratamento, Estudo de Caso. 13ª ed. Filadélfia: Pa WB Saunders, 1944.

STUART, A.A. Test for Homogeneity of the Marginal Distributions in a Two-Way Classification. Biometrika, v. 42, n. 3/4, p. 412–416, 1955.

VERGHESE, V.P. et al. Early Childhood Neurodevelopmental Outcomes in Infants Exposed to Infectious Syphilis In Utero. The Pediatric Infectious Disease Journal [Internet], vol. 37(6), p. 576–9, 2018 Jun 1. Disponível em: https://pubmed.ncbi.nlm.nih.gov/29189610. Acesso em: 21 maio 2023.

WAN, Z. et al. Factors associated with congenital syphilis: A retrospective study in Jiangxi Province, China. International Journal of STD & AIDS, vol. 33(2), p. 156-163, 2022.

WICHER, V.; WICHER, K. Pathogenesis of maternal-fetal syphilis revisited. Clin Infect Dis. Epub, 2001 Jun 25.

WIJESOORIYA, N.S. et al. Global burden of maternal and congenital syphilis in 2008 and 2012: a health systems modelling study. Lancet Global Health, vol. 4.8, p. e525–e533, 2016.

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2023-11-27

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