Impact of Prenatal Care Coverage on Miscarriage and Stillbirth Rates Caused by Syphilis in Brazilian States from 2014 to 2023

Abstract

This study evaluated the correlation between the rate of prenatal care among women with gestational syphilis and adverse outcomes, such as miscarriage and stillbirth, in Brazilian states between 2013 and 2023. Syphilis, an infection caused by Treponema pallidum, has multiple stages and can be vertically transmitted, especially in the first trimester, increasing the risk of fetal complications. Despite Brazil’s high prenatal care coverage rate, access barriers still hinder proper follow-up, particularly among vulnerable populations. Data collected from DATASUS showed a significant increase in the incidence of gestational syphilis during the period, highlighting a public health concern. Statistical analysis revealed inverse correlations between inadequate prenatal care and the incidence of gestational syphilis, particularly in the North, Northeast, and Southeast regions, indicating that increased prenatal coverage reduces infection rates and associated adverse outcomes. However, some states presented complex relationships, such as Ceará, where positive correlations were observed between inadequate prenatal care and miscarriages or stillbirths. Among the positive results, the state of Paraná stands out, where initiatives such as the Rede Mãe Paranaense contributed to greater adequacy of prenatal care, improved detection of gestational syphilis, and a possible reduction in adverse outcomes, serving as an example of an effective action that can be replicated in other regions. The findings reinforce the importance of expanding access to quality prenatal care, especially in regions with high syphilis rates, to reduce adverse outcomes and strengthen strategies to combat gestational syphilis in Brazil.