Analysis of the maternal and congenital syphilis surveillance system, Hospital Materno Infantil José Domingo De Obaldía, Chiriquí, Republic of Panama, 2010 to 2021.

Abstract

Introduction. According to passive surveillance systems in Panama there were 2.9 cases of maternal syphilis per 1,000 live births in 2017-2020. We aimed to characterize maternal and congenital syphilis at the Women's and Children's Hospital José Domingo De Obaldía. Population and Methods. We evaluated data on pregnant women, deliveries, abortions, and stillbirths at this hospital in 2010-2021. We search laboratory records, patient files, prenatal control cards and interviewed pregnant, and puerperal patients to find those with a positive syphilis test without adequate treatment and followed for fetal outcomes. We calculated means and proportions, rates and ratios. Results. In 2010-2021 there were 101,493 total births, and 1,960 cases of maternal syphilis, for a rate of 19.3 per 1,000 births. The mean maternal age was 26 years. Most cases (81.9%) had a prenatal control card. Of the 1,960 pregnant women considered as cases, 1,709 (87.2%) had live births, 171 (8.7%) abortions, 67 (3.4%) fetal deliveries, and 13 (0.7%) ectopic pregnancies. Only 30 (1.8%) were symptomatic congenital syphilis. The incidence of in-hospital congenital syphilis and perinatal mortality from this condition was 16.5 per 1,000 and 2.6 per 1,000 total births with a case-fatality rate of 5.4%. Discussion. The incidence of in-hospital congenital syphilis was seven times that of the country. The findings highlight the lack of adequate treatment and missed opportunities for prenatal visits. We recommend reinforcing the active search in pregnant women and their partners. The data is a warning on the neglect of syphilis and other sexually transmitted diseases.