Prenatal syphilis and adverse pregnancy outcomes in women with HIV receiving ART in Brazil: a population-based study
Bibliographic record
Abstract
Background: We aimed to examine factors associated with prenatal syphilis, including prenatal care, and pregnancy outcomes of pregnant women with HIV in Brazil. Methods: Retrospective data were gathered from a national cohort of Brazilian women with HIV on antiretroviral therapy who became pregnant between January 2015 and May 2018. Prenatal syphilis was defined by clinical diagnoses with treatment or any positive syphilis laboratory result between 30 days before conception and pregnancy conclusion. Multivariable logistic regression models examined factors associated with prenatal syphilis risk and adverse pregnancy outcomes (including stillbirth, abortion, preterm delivery, small for gestational age, and congenital abnormalities). Receipt of recommended prenatal syphilis screening and adequacy of prenatal care were also evaluated. Findings: /Indigenous race (13.7/7.7/8.3% vs. 5.8% in White women), those of younger age (median age 25.9 years vs. 27.6 in total cohort) and those with crack/cocaine use during/before pregnancy (20%). Of 1042/2169 women with prenatal care and screening data, 475 (46%) received inadequate prenatal care and only 301 (29%) received the recommended antenatal syphilis screening. Prenatal syphilis was not associated with adverse pregnancy outcomes (aOR 0.91 [0.64-1.30]). Interpretation: Prenatal syphilis was prevalent in this cohort of pregnant women with HIV. Prenatal syphilis was not associated with adverse pregnancy outcomes. Attention to syphilis prevention and treatment is especially needed in marginalised women. Funding: Brazilian Ministry of Health and United States' National Institutes of Health.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".