RESUMO
BACKGROUND: Preterm birth (PTB) is a major determinant of neonatal morbimortality with adverse consequences for health. The causes are multifactorial, with intrauterine infection probably explaining most of these outcomes. It is believed that infection with Chlamydia trachomatis (CT) is also involved in PTB and premature rupture of membranes. OBJECTIVES: To evaluate the prevalence of and associated factors for CT among cases of PTB attended at a University Hospital in Vitoria, Brazil. METHODS: A cross-sectional study performed among parturient who had preterm birth from June 2012 to August 2013 in Vitoria, Brazil. Participants answered a questionnaire including demographic, behavioral, and clinical data. A sample of urine was collected and screened for CT using polymerase chain reaction. Chi-square tests were used for proportion differences and Student's-t tests and variance analysis were used for testing differences between mean values. Odds ratio was used as a measure of association with a 95% confidence interval. RESULTS: The prevalence of PTB during the period of the study was 26% and the prevalence of CT among them was 13.9%. A total of 31.6% pregnant women were younger than 25 years old and women infected by CT were even younger than women not infected by CT (p = 0.022). Most of them (76.2%) were married or had a living partner, and CT infection was more frequent among the single ones (p = 0.018); 16.7% of women reported their first sexual intercourse under 14 years old. The causes of prematurity were maternal-fetal in 40.9%; rupture of the membranes in 29.7% and premature labor in 29.4%. In multivariate analysis, being married was a protective factor for infection [OR = 0.48 (95%CI:0.24-0.97)]. None of the other characteristics were associated with CT infection. CONCLUSIONS: This study shows a high prevalence of CT infection among parturient who have preterm birth. This high prevalence highlight the need for defining screening strategies focused on young pregnant women in Brazil.
Assuntos
Infecções por Chlamydia/microbiologia , Chlamydia trachomatis/patogenicidade , Nascimento Prematuro/epidemiologia , Adulto , Brasil , Infecções por Chlamydia/complicações , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/urina , Chlamydia trachomatis/isolamento & purificação , Feminino , Hospitais Universitários , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/microbiologia , Nascimento Prematuro/patologia , Fatores de Risco , Parceiros Sexuais , Adulto JovemRESUMO
OBJECTIVE: To estimate the prevalence of HIV, hepatitis B (HBV) and C (HCV), and syphilis infections and associated risk exposures in a population-based sample of young women in Vitória, Brazil. METHODS: From March to December 2006, a cross-sectional sample of women aged 18-29 years was recruited into a single stage, population-based study. Serological markers of HIV, HBV, HCV, and syphilis infections and associated risk exposures were assessed. RESULTS: Of 1,200 eligible women, 1,029 (85.8%) enrolled. Median age was 23 (interquartile range 20-26) years; 32.2% had < or = 8 years of education. The survey weighted prevalence estimates were: HIV, 0.6% [(95% CI), 0.1%, 1.1%]; anti-HBc, 4.2% (3.0%, 5.4%); HBsAg, 0.9% (0.4%, 1.6%); anti-HCV, 0.6% (0.1%, 1.1%), and syphilis 1.2% (0.5%, 1.9%). Overall, 6.1% had at least one positive serological marker for any of the tested infections. A majority (87.9%) was sexually active, of whom 12.1% reported a previously diagnosed sexually transmitted infection (STI) and 1.4% a history of commercial sex work. Variables independently associated with any positive serological test included: older age (> or = 25 vs. < 25 years), low monthly income (< or = 4x vs. > 4x minimum wage), previously diagnosed STI, > or = 1 sexual partner, and any illicit drug use. CONCLUSIONS: These are the first population-based estimates of the prevalence of exposure to these infectious diseases and related risks in young women, a population for whom there is a scarcity of data in Brazil.