OBJECTIVE: To identify psychosocial, sociodemographic, and clinical factors associated with adherence to gestational syphilis treatment. METHOD: cross-sectional study with a sample of 325 pregnant women diagnosed with syphilis during pregnancy. The main outcome was complete adherence to the therapeutic regimen of three doses of penicillin, including the partner's treatment. Data were collected through structured interviews and medical records. Statistical analysis included logistic regressions and co-occurrence network analysis to explore interrelationships between factors associated with treatment adherence. RESULTS: Treatment adherence was observed in 43.6% of pregnant women and their partners. Newborns of mothers who adhered to treatment had significantly higher Apgar and Capurro scores. Positive factors associated with adherence included early diagnosis in the first trimester (odds ratio OR: 5.12, 95% confidence intervals CI: 2.8-9.7), adequate prenatal follow-up (OR: 4.37, CI: 2.5-7.7), planned pregnancy (OR: 2.36, CI: 1.3-4.1), employment (OR: 1.72, CI: 1.1-2.7), and income above the minimum wage (OR: 1.71, CI: 1.1-2.6). Negative factors included a history of substance misuse during life and pregnancy (OR: 0.34, CI: 0.1-0.7), childhood maltreatment (OR: 0.53, CI: 0.3-0.8), recurrent unprotected sex (OR: 0.61, CI: 0.3-0.9), marital conflicts (OR: 0.47, CI: 0.3-0.7), witnessed violence (OR: 0.51, CI: 0.3-0.8), and prior police detention (OR: 0.29, CI: 0.1-0.5). Network analysis revealed three clusters related to these factors: one associated with violence, another with substance use, and another involving socioeconomic factors and prenatal care access. CONCLUSION: Adverse maternal psychosocial factors, such as violence, maltreatment, and substance use, hamper treatment adherence and may contribute to worse neonatal outcomes.
Fantinelli et al. (Sat,) studied this question.