Migration, vulnerability, and congenital syphilis in maternal and child health: A cross-sectional study in Brazil

Abstract

This study aimed to evaluate how sociodemographic and care-related inequalities affect the management of congenital syphilis in a public maternity hospital in Brazil’s far-north border region, considering Venezuelan migration as a contextual factor. We conducted an observational, cross-sectional, analytical study using 235 congenital syphilis notification forms extracted from the database of the state referral maternity hospital in Roraima, Brazil, between January and December 2023. Brazilian and Venezuelan migrant pregnant women were compared across sociodemographic, clinical, and care variables, applying statistical tests (chi-square or Fisher’s exact for proportions; Mann-Whitney for non-normally distributed continuous variables). Migrants accounted for 39.1% of cases and had lower schooling and labor-market participation. Prenatal care coverage and screening were lower among migrants: prenatal VDRL testing 37.0% vs 58.0% (p=0.002) and treponemal tests 65.2% vs 79.7% (p=0.02), considering Venezuelan and Brazilian women, respectively; late diagnosis was more frequent among migrants (42.4% vs 27.3%; p=0.02). Adequate treatment was low in both groups (10.9% vs 14%; p=0.49). Neonatal assessment revealed gaps in clinical and therapeutic follow-up regardless of maternal nationality. Venezuelan migration exacerbates pre-existing inequities and access barriers, undermining the management of gestational and congenital syphilis. Intersectoral actions are needed to expand timely prenatal care, strengthen surveillance, and promote culturally responsive care in border settings.