Prevalência da sífilis congênita em recém-nascido no contexto mundial: revisão sistemática.
Notice bibliographique
Résumé
Qualified perinatal care consists of providing care to pregnant women from pregnancy to delivery, as a way of promoting a healthy pregnancy. However, ensuring a healthy pregnancy comes up against maternal morbidities, such as syphilis in pregnant women, in addition to the risk of vertical transmission to the fetus. Objective: Estimate the prevalence of congenital syphilis in newborns in the global context. Method: This is a systematic review with meta-analysis. To construct the guiding question: “What is the prevalence of congenital syphilis in the global context?” I use the acronym PECOT (Population, Exposure, Comparator, Outcomes, Study Type). The search took place in the following databases: Embase, PubMed, Scopus, Ebsco, Web of Science, Latin American and Caribbean Literature in Health Sciences. As a search strategy, a combination of descriptors indexed in Medical Subject Headings was adopted: Pregnancy; Syphilis Infectious Disease Transmission, Vertical; Observational Study, intermediated by the Boolean operators “AND” and “OR”. As inclusion criteria, observational studies on the vertical transmission of gestational syphilis and the association of gestational syphilis with congenital syphilis were included. There were no language or time restrictions for selecting studies. The systematic review period was June to November 2023. The selection of articles and data extraction were carried out by two independent, blinded reviewers, using the Rayyan Intelligent Systematic Review software and based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. In assessing the quality of evidence of the included data, the Grading of Recommendations Assessment, Developing and Evaluation method was chosen, while, for the analysis of risk of bias, the Newcastle-Ottawa Scale and the checklist of Joanna Briggs Institute Critical Appraisal tools for use in JBI Systematic Reviews. The review protocol was submitted to the International Prospective Register of Systematic Reviews database, registered under number CRD 42022349359, and, as it was research data already published in a scientific database, the Ethics Committee was waived in Search. Results: In total, 6,268 studies were identified in the databases. The sample consisted of 15 studies (eight cohort studies; two case-control; five cross-sectional studies). The research took place mainly in the United States of America, Brazil and China, and from 1995 to 2022. As a diagnosis of the disease, the rapid treponemal test predominated in studies and benzathine penicillin G was the drug of choice for treatment. As an effect of transmission, the complications found in newborns were: congenital syphilis and adverse events associated with prematurity, low birth weight and fetal/neonatal mortality. The main cause of verticalization was associated with incomplete treatment of syphilis during pregnancy and late diagnosis of the disease in the third trimester. The global prevalence of congenital syphilis corresponded to 30.75% (95% CI, 0.17-0.50; I²=99%) and the prevalence of transmission showed that untreated pregnant women increased by 5.49% (95% CI, 0.59-51.31; I²= 97%) the possibility of vertical transmission. Conclusion: Despite the high number of studies identified in the databases, regardless of period and language, only 15 studies primarily contextualized the global reality of congenital syphilis and its association with gestational syphilis. However, the outcome of vertical transmission continues to be represented by the lack of treatment for gestational syphilis
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,045 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,006 | 0,007 |
| Bibliométrie | 0,016 | 0,017 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».