OBJECTIVE: to estimate the prevalence of HIV and syphilis, and their association with gestational complications and newborn outcomes in women admitted for delivery at a mother and child center in the South of Brazil.
METHODS: cross-sectional study based on the review of electronic medical records of parturients (March/2016 to June/2018). Sociodemographic and clinical data were analyzed. HIV and syphilis were considered outcomes, then exposures to assess associations with pregnancy and neonatal variables. Prevalence Ratio (PR) were calculated using Poisson Regression with robust variance and 95% Confidence Interval (CI).
RESULTS: data from 6,527 women were evaluated. HIV prevalence was 0.6% and syphilis 1.5%. Women assisted by the public health system [PR=2.28 95%CI=1.07-4.82 for syphilis; PR=3.52 95%CI=1.06-11.72 for HIV] and drug users [PR=5.47 95%CI=2.49-12.04 for syphilis; PR=4.76 95%CI=1.12-20.19 for HIV] were more affected. Syphilis was more prevalent among younger and non-white women (p=0.001). Adequate prenatal care reduced syphilis by 38% (PR= 0.62 95%CI=0.39-0.97; p=0.006). Neonatal complications occurred in 32.3% of syphilis cases and 17.1% of HIV cases. Of the 98 syphilis cases, 29.6% led to congenital syphilis.
CONCLUSION: women in socially vulnerable conditions, such as drug users, were more affected. Congenital syphilis exceeded the national average, reinforcing the need for timely and comprehensive prenatal care.

Palavras-chave: Syphilis, HIV seropositive, Congenital syphilis, Sexually transmitted diseases, High-risk pregnancy

OBJECTIVES: the objective this study was evaluating the prevalence of maternal colonization by Group B beta-hemolytic Streptococcus (GBS) in pregnant women who delivered preterm and its relationship with adverse maternal/perinatal outcomes.
METHODS: we carried out a retrospective cohort study with singleton pregnancies with or without a culture for GBS (vaginal-rectum) who delivered spontaneously <37 weeks of gestation.
RESULTS: the study included 190 pregnant women, 53.1% (101/190) did not undergo culture for GBS and 46.8% (89/101) have done. Among the patients who had a culture, 13.5% (12/89) had positive culture for GBS and 86.5% (77/89) had a negative culture. Pregnant women without GBS culture had higher prevalence of preterm birth (74.3 vs. 59.6%, p=0.031) and lower prevalence of antibiotic prophylaxis (27.7 vs. 56.2%, p<0.001) than pregnant women with GBS culture. Higher prevalence of crystalline penicillin G use was observed in pregnant women with positive culture compared to pregnant women with negative culture for GBS (100 vs. 39%, p<0.0001). There was no significant association between pregnant women with or without a culture for GBS or positive and negative GBS cultures and adverse maternal/perinatal outcomes.
CONCLUSION: No significant association was found between GBS culture or not, GBS positive or negative culture, adequate or inadequate GBS prophylaxis, and the prevalence of adverse maternal/perinatal outcomes.

Palavras-chave: Group B beta-hemolytic Streptococcus, Screening, Preterm delivery, Antibiotic prophylaxis, Adverse maternal/perinatal outcomes

Hypertensive disorders in pregnancy, particularly preeclampsia, represent a global public health issue and are the leading cause of maternal mortality in Brazil, accounting for 20% of maternal deaths. Despite advancements in prevention, disparities persist, especially in low- and middle-income countries, where calcium intake is often below recommended levels. This article reviews the evidence supporting calcium supplementation as an effective strategy for preventing preeclampsia, with benefits extending beyond blood pressure control. Systematic review data from the Cochrane Library highlight a reduction in preeclampsia, maternal morbidity, and preterm birth among women who supplement and have low calcium intake. However, recent debates have questioned the universality of this recommendation, suggesting supplementation only for high-risk pregnancies. These controversies arise from methodological limitations in sensitivity analyses and misinterpretations. Nevertheless, the World Health Organization guidelines advocate calcium supplementation of 1.5-2 g/day for pregnant women in regions with low calcium intake. This recommendation aligns with findings demonstrating improved maternal and neonatal outcomes, emphasizing the need for widespread implementation. Urgent national policies in Brazil are required to ensure equitable access to calcium, particularly given the high prevalence of preeclampsia and maternal mortality.

Palavras-chave: High-risk pregnancy, Calcium, Preeclampsia, Maternal mortality, Public health

OBJETIVOS: estimar a proporção de soroconversão da criança exposta ao HIV e verificar os fatores de risco associados, no período de 2007-2017 em Santa Catarina.
MÉTODOS: o delineamento utilizado foi de coorte histórica e os dados obtidos no Sistema de Informação de Agravos de Notificação (SINAN) que registra as gestantes infectadas e as crianças expostas ao HIV. As crianças foram acompanhadas pelo serviço de saúde desde o nascimento até o 18º mês de vida, para determinar a ocorrência de soroconversão pelo HIV.
RESULTADOS: foram identificadas 5.554 gestantes infectadas pelo HIV com média de idade de 26,7±6,5 anos, predomínio da raça branca, baixa escolaridade e que receberam o diagnóstico para o HIV até o 2º trimestre gestacional. Foram incluídas 4.559 fichas de crianças expostas ao HIV, das quais 130 casos (2,9%) de soroconversão foram confirmados. O não uso de antirretroviral durante a gestação (OR=9,31, IC95%=5,97-14,52; p<0,001) e aleitamento materno (OR=3,10, IC95%=1,34-7,20; p=0,008) foram fatores de risco independentes para a soroconversão.
CONCLUSÕES: esses dados demonstram lacunas na assistência pré-natal, quanto a adesão ao tratamento e acompanhamento de mães infectadas pelo HIV, resultando em casos novos de HIV entre crianças, que poderiam ser evitados.

Palavras-chave: HIV, Síndrome de imunodeficiência adquirida, Soroconversão, Transmissão vertical de doença infecciosa, Fatores de risco