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BMC Infect Dis. 2019 Mar 29;19(1):292. doi: 10.1186/s12879-019-3896-4.

Syphilis-attributable adverse pregnancy outcomes in China: a retrospective cohort analysis of 1187 pregnant women with different syphilis treatment.

Liu H1,2,3, Chen N1,2, Yu J2, Tang W4, He J1,2, Xiao H2, Lin S2, Hu F1,2, Feng Q2, Tucker JD4,5, Xia H6,7, Qiu X8,9,10.

Author information

1
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China.
2
Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China.
3
Department of Obstetrics and Gynecology, Guangzhou Women and Children Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China.
4
Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, North Carolina, 27599, USA.
5
Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
6
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China. huimin.xia@bigcs.org.
7
Department of Neonatal Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China. huimin.xia@bigcs.org.
8
Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China. qiu.xiu@bigcs.org.
9
Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China. qiu.xiu@bigcs.org.
10
Department of Obstetrics and Gynecology, Guangzhou Women and Children Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, China. qiu.xiu@bigcs.org.

Abstract

BACKGROUND:

Syphilis is responsible for a substantial burden of preventable adverse outcomes in pregnancy. The purpose of this study was to compare the frequency of adverse pregnancy outcomes among syphilis-seropositive women who received different treatment regimens at different times in Guangzhou, China.

METHODS:

Pregnant women with syphilis infection who received prenatal and delivery services in Guangzhou between January 2014 and December 2016 were included. Association between treatment status and the composite adverse outcomes (preterm birth, infant smaller than gestational age, stillbirth, and spontaneous abortion) was estimated.

RESULTS:

Of 1187 syphilis-seropositive pregnant women included in the analysis, 900 (75.8%) syphilis-seropositive pregnant women received treatment, and 287(24.2%) did not receive treatment. Adverse pregnancy outcomes were observed among 16.3% (147/900) of women with treatment and 33.8% (97/287) of women without treatment. Syphilis-seropositive pregnant women treated with one or two courses of penicillin had a similar risk of adverse pregnancy outcomes (adjusted RR = 1.36, 95% CI: 0.94-1.96). Adverse outcomes were more common among women whose non-treponemal serum test titer was >1:8 and received treatment after 28 weeks compared to before 28 weeks (adjusted RR = 2.34, 95% CI: 1.22-4.48).

CONCLUSIONS:

Women who received one course of penicillin and women who received two courses of penicillin had a similar risk of adverse pregnancy outcomes. Syphilis treatment before 28 weeks of pregnancy is critical. Strategies to promote high-quality prenatal services are needed.

KEYWORDS:

Adverse outcomes; Pregnant women; Syphilis; Treatment

PMID:
30925908
PMCID:
PMC6439997
DOI:
10.1186/s12879-019-3896-4
[Indexed for MEDLINE]
Free PMC Article

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