{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:32:37Z","timestamp":1789014757770,"version":"build-2803163510"},"reference-count":35,"publisher":"FapUNIFESP (SciELO)","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"abstract":"<jats:p>Abstract: To assess the adequacy of prenatal care offered in the Brazilian capital cities and the diagnosis of gestational syphilis through public data from health information systems. The modified Kotelchuck index for adequacy of prenatal care was built using Brazilian Information System on Live Births (SINASC) data. Data on gestational syphilis, congenital syphilis, estimated population coverage by the Family Health Strategy (FHS), the Municipal Human Development Index (MHDI) and data from National Program for Access and Quality Improvement in Primary Care (PMAQ-AB) were accessed in public sites. The profile of pregnant women associated with inadequate care was assessed by logistic regression. In total, 685,286 births were analyzed. Only 2.3% of women did not attend prenatal appointments. The mean adequacy was 79.7%. No correlation was found between adequacy of prenatal care and FHS coverage (p = 0.172), but a positive correlation was found with the MHDI (p &lt; 0.001). Inadequacy of prenatal care was associated with age below 20 years old, schooling less than 4 years, non-white skin color and not having a partner. Among the congenital syphilis cases, 17.2% of mothers did not attend prenatal care. Gestational syphilis more often affected vulnerable women, including a higher proportion of adolescents, women with low schooling, and women of non-white color. The PMAQ-AB showed a median availability of 27.3% for syphilis rapid tests, 67.7% for benzathine penicillin, and 86.7% for benzathine penicillin administration by health teams. The use of public data showed a low adequacy of prenatal care in Brazilian capitals, denoting insufficient quality for the diagnosis and treatment of gestational syphilis, despite the availability of supplies. Continuous monitoring can be carried out using public data, indicating to local strategies to eliminate congenital syphilis.<\/jats:p>","DOI":"10.1590\/0102-311x00057219","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T08:52:16Z","timestamp":1576831936000},"source":"Crossref","is-referenced-by-count":35,"title":["Adequacy of prenatal care, diagnosis and treatment of syphilis in pregnancy: a study with open data from Brazilian state capitals"],"prefix":"10.1590","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5789-0695","authenticated-orcid":false,"given":"Adele Schwartz","family":"Benzaken","sequence":"first","affiliation":[{"name":"Funda\u00e7\u00e3o de Medicina Tropical Doutor Heitor Vieira Dourado,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8886-1662","authenticated-orcid":false,"given":"Gerson Fernando Mendes","family":"Pereira","sequence":"additional","affiliation":[{"name":"Minist\u00e9rio da Sa\u00fade,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5441-1006","authenticated-orcid":false,"given":"Alessandro Ricardo Caruso da","family":"Cunha","sequence":"additional","affiliation":[{"name":"Minist\u00e9rio da Sa\u00fade,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2882-2861","authenticated-orcid":false,"given":"Flavia Moreno Alves de","family":"Souza","sequence":"additional","affiliation":[{"name":"Minist\u00e9rio da Sa\u00fade,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7360-6490","authenticated-orcid":false,"given":"Val\u00e9ria","family":"Saraceni","sequence":"additional","affiliation":[{"name":"Secretaria Municipal de Sa\u00fade,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2020]]},"reference":[{"key":"ref1","series-title":"Avalia\u00e7\u00e3o em sa\u00fade: dos modelos conceituais \u00e0 pr\u00e1tica na an\u00e1lise da implanta\u00e7\u00e3o de programas online","author":"Hartz ZMA","year":"1997"},{"key":"ref2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0143304","article-title":"Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting","volume":"10","author":"Newman L","year":"2015","journal-title":"PLoS One"},{"key":"ref3","series-title":"Boletim Epidemiol\u00f3gico de S\u00edfilis - 2018","year":"2018"},{"key":"ref4","series-title":"Manual de vigil\u00e2ncia do \u00f3bito infantil e fetal e do Comit\u00ea de Preven\u00e7\u00e3o do \u00d3bito Infantil e Fetal","year":"2009"},{"key":"ref5","first-page":"803","article-title":"A case-control study of stillbirths at a teaching hospital in Zambia, 1979-80 serological investigations for selected infectious agents","volume":"62","author":"Watts TE","year":"1984","journal-title":"Bull World Health Organ"},{"key":"ref6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001396","article-title":"Global estimates of syphilis in pregnancy and associated adverse outcomes analysis of multinational antenatal surveillance data","volume":"10","author":"Newman L","year":"2013","journal-title":"PLoS Med"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s12913-019-3953-0","article-title":"Can the primary health care model affect the determinants of neonatal, post-neonatal and maternal mortality A study from Brazil","volume":"19","author":"Guerra AB","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1590\/S0102-311X2011001000011","article-title":"Fatores de risco para mortalidade materna em \u00e1rea urbana do Nordeste do Brasil","volume":"27","author":"Leite RMB","year":"2011","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1590\/S0102-311X2012001100016","article-title":"Diferenciais nos fatores de risco para a mortalidade infantil em cinco cidades brasileiras um estudo de caso-controle com base no SIM e no SINASC","volume":"28","author":"Maia LTS","year":"2012","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.2105\/AJPH.84.9.1414","article-title":"An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index","volume":"84","author":"Kotelchuck M","year":"1994","journal-title":"Am J Public Health"},{"key":"ref11","article-title":"Portaria n\u00ba 1.459, de 24 de junho de 2011. 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O uso da penicilina na aten\u00e7\u00e3o prim\u00e1ria para a preven\u00e7\u00e3o da s\u00edfilis cong\u00eanita","year":"2016"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"e359","DOI":"10.1093\/pubmed\/fdx132","article-title":"The impact of the Brazilian Family Health Strategy and the conditional cash transfer on tuberculosis treatment outcomes in Rio de Janeiro an individual-level analysis of secondary data","volume":"40","author":"Durovni B","year":"2018","journal-title":"J Public Health (Oxf)"},{"key":"ref34","series-title":"Sa\u00fade Brasil 2017: uma an\u00e1lise da situa\u00e7\u00e3o de sa\u00fade e os desafios para o alcance dos objetivos e desenvolvimento sustent\u00e1vel","year":"2018"},{"key":"ref35","series-title":"Agenda de a\u00e7\u00f5es estrat\u00e9gicas para redu\u00e7\u00e3o da s\u00edfilis cong\u00eanita no Brasil","year":"2016"}],"container-title":["Cadernos de Sa\u00fade P\u00fablica"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/csp\/v36n1\/1678-4464-csp-36-01-e00057219.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T15:30:27Z","timestamp":1596209427000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-311X2020000105011&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020]]}},"alternative-id":["S0102-311X2020000105011"],"URL":"https:\/\/doi.org\/10.1590\/0102-311x00057219","relation":{},"ISSN":["1678-4464","0102-311X"],"issn-type":[{"value":"1678-4464","type":"electronic"},{"value":"0102-311X","type":"print"}],"subject":[],"published":{"date-parts":[[2020]]},"article-number":"e00057219"}}