Entre números e histórias: uma análise sobre a Sífilis gestacional e congênita na Baixada Santista

Abstract

Gestational and congenital syphilis remain a public health challenge, despite the availability of effective diagnostic methods and treatment, reflecting social inequalities and weaknesses in prenatal care that sustain vertical transmission. This study aimed to analyze the temporal variation of gestational and congenital syphilis in the Metropolitan Region of Baixada Santista and the perceptions of women who experienced syphilis during pregnancy and whose children were diagnosed with congenital syphilis. This is a mixed-methods study with a convergent-parallel design, descriptive and exploratory in nature, including analysis of secondary data from DATASUS/SINAN (2009–2023) and a qualitative stage based on semi-structured interviews conducted at Hospital Guilherme Álvaro, in Santos. All reported cases were included and analyzed using descriptive statistics, rate calculations, and Joinpoint regression, in addition to thematic analysis with five women. The study was approved by a Research Ethics Committee. The results showed an increase in cases over the historical series, followed by stabilization, with predominance among young women, especially those identified as mixed-race, with a relevant presence of adolescents and a high proportion of missing data. Congenital syphilis remained at high levels, indicating persistent vertical transmission and failures in prenatal care. The narratives revealed lack of knowledge about the infection, feelings of fear and guilt, difficulties in care, and significant emotional impact associated with the child’s illness. The integration of findings demonstrates that the persistence of the condition results from the interplay between social vulnerabilities and weaknesses in the quality of care, particularly in communication, continuity of care, and organization of health services. The findings highlight the need to strengthen prenatal care, with emphasis on timely diagnosis, effective treatment, and health communication, as well as improving the integration between care and surveillance to reduce vertical transmission and promote more comprehensive, equitable, and effective care.