Maternal syphilis treatment and pregnancy outcomes: a retrospective study in Jiangxi Province, China

Wan, Zhihua; Zhang, Huan; Xu, Haigang; Hu, Yang; Tan, Cai; Tao, Yuling

doi:10.1186/s12884-020-03314-y

Cited by 21 publications

(26 citation statements)

References 16 publications

(18 reference statements)

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“…Another study from Brazil showed that among women attending a prenatal program, one to three PNC visits were associated with nonperformance tests for syphilis ( 29 ). Studies conducted in China showed an association between the timing of first treatment for syphilis to adverse pregnancy outcomes and CS ( 30 , 31 ), evidencing the importance of timing of the first PNC visit. In Brazil, after a positive syphilis reagent test (rapid syphilis test or VDRL), treatment can be provided during the same visit.…”

Section: Discussionmentioning

confidence: 98%

Determinants of gestational syphilis among women attending prenatal care programs in the Brazilian Amazon

Uchôa

Araújo

Silva

et al. 2022

Front. Public Health

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BackgroundThere was a high proportion of pregnant women who were attending prenatal care who were not tested for syphilis or tested but not treated, among priority countries. The coverage for prenatal care visits, syphilis screening, and treatment are priority indicators for monitoring of the elimination of syphilis. The aim was to determine the factors associated with gestational syphilis among postpartum women who were in a prenatal care program in the Brazilian Amazon.MethodsAn unmatched case–control study was conducted at the hospital in Brazil. Data collection was carried out from November 2020 to July 2021 during hospitalization using a pretested structured questionnaire. The criteria for selection of cases and control followed the guidelines established by the Ministry of Health of Brazil; postpartum women with a laboratory diagnosis based on treponemal and/or nontreponemal tests, symptoms of syphilis or asymptomatic, treatment or not treated, and in a prenatal care program. Gestational syphilis cases were identified as women who tested positive for syphilis, and those who tested negative were controls, at minimally one prenatal care visit, childbirth, and/or the puerperium. The sample size encompassed 59 cases and 118 controls (1: 2 ratio of cases to controls). Data were analyzed using Minitab 20® and BioEstat 5.3® software. The odds ratio was calculated by multiple logistic regression.ResultsOne hundred and seventy-seven postpartum women were included in the study, 59 cases and 118 controls. Among all participants, 95.5% (169) were tested for syphilis in any trimester during pregnancy and at the delivery and 4.5% (8) were tested in the maternity only, at the time childbirth and/or puerperium. The final multiple logistic regression model evidenced that cases had higher odds compared to controls if they had past history of sexually transmitted infections (AOR: 55.4; p: 0.00), difficulty talking about condom use with their sexual partner (AOR: 4.92; p: 0.01), one to six prenatal care visits (AOR: 4.93; p: 0.01), had not received a sexually transmitted infections test result in the maternity hospital (AOR: 4.09; p: 0.04), lower monthly income (AOR: 4.32; p: 0.04), or one to three miscarriages (AOR: 4.34; p: 0.01).ConclusionThe sociodemographic, programmatic, obstetric, and sexual factors are associated with gestational syphilis among postpartum women.

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Section: Discussionmentioning

confidence: 98%

Determinants of gestational syphilis among women attending prenatal care programs in the Brazilian Amazon

Uchôa

Araújo

Silva

et al. 2022

Front. Public Health

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“…There was a significant relationship between birth asphyxia and women with syphilis infection. Maternal syphilis infection in pregnancy has been shown in other studies to lead to adverse birth outcomes including; spontaneous abortions, preterm birth, stillbirth and newborns who are small for gestational age [ 49 ]. Important to note is that, in Uganda, routine screening for syphilis is done at the initial antenatal visit and treatment offered to those who are infected [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study

Ayebare

Hanson

Nankunda

et al. 2022

BMC Pregnancy Childbirth

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Background Birth asphyxia is one of the leading causes of neonatal mortality worldwide. In Uganda, it accounts for 28.9% of all neonatal deaths. With a view to inform policy and practice interventions to reduce adverse neonatal outcomes, we aimed to determine the prevalence and factors associated with birth asphyxia at two referral hospitals in Northern Uganda. Methods This was a cross-sectional study, involving women who gave birth at two referral hospitals. Women in labour were consecutively enrolled by the research assistants, who also attended the births and determined Apgar scores. Data on socio-demographic characteristics, pregnancy history and care during labour, were obtained using a structured questionnaire. Participants were tested for; i) malaria (peripheral and placental blood samples), ii) syphilis, iii) white blood cell counts (WBC), and iv) haemoglobin levels. The prevalence of birth asphyxia was determined as the number of newborns with Apgar scores < 7 at 5 min out of the total population of study participants. Factors independently associated with birth asphyxia were determined using multivariable logistic regression analysis and a p-value < 0.05 was considered statistically significant. Results A total of 2,930 mother-newborn pairs were included, and the prevalence of birth asphyxia was 154 [5.3% (95% confidence interval: 4.5- 6.1)]. Factors associated with birth asphyxia were; maternal age ≤ 19 years [adjusted odds ratio (aOR) 1.92 (1.27–2.91)], syphilis infection [aOR 2.45(1.08–5.57)], and a high white blood cell count [aOR 2.26 (1.26–4.06)], while employment [aOR 0.43 (0.22–0.83)] was protective. Additionally, referral [aOR1.75 (1.10–2.79)], induction/augmentation of labour [aOR 2.70 (1.62–4.50)], prolonged labour [aOR 1.88 (1.25–2.83)], obstructed labour [aOR 3.40 (1.70–6.83)], malpresentation/ malposition [aOR 3.00 (1.44–6.27)] and assisted vaginal delivery [aOR 5.54 (2.30–13.30)] were associated with birth asphyxia. Male newborns [aOR 1.92 (1.28–2.88)] and those with a low birth weight [aOR 2.20 (1.07–4.50)], were also more likely to develop birth asphyxia. Conclusion The prevalence of birth asphyxia was 5.3%. In addition to the known intrapartum complications, teenage motherhood, syphilis and a raised white blood cell count were associated with birth asphyxia. This indicates that for sustained reduction of birth asphyxia, appropriate management of maternal infections and improved intrapartum quality of care are essential.

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“…Currently, most national studies have only investigated the relationship between treatment during pregnancy and pregnancy outcome in pregnant women with syphilis infection [ 8 – 11 ], and few studies have evaluated the relationship between their treatment during pregnancy and the conversion of syphilis-specific antibodies in those children exposed to syphilis. It is worth mentioning that the change in serological titers before and after treatment was not identical in each pregnant woman with syphilis infection.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Adverse Pregnancy Outcomes of Pregnant Women with Syphilis and Maternal-Infant Serological Association in Changzhou, China, 2015–2019

Bian

Qin

Zhang

et al. 2022

Stem Cells International

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Background. Although the prevention of mother-to-child transmission of syphilis program in China has achieved national coverage for 7 years, controversy still exists regarding the treatment of syphilis and the serological significance of syphilis. Objective. To explore the occurrence and influencing factors of adverse pregnancy outcomes among pregnant women with syphilis in Changzhou from 2015-2019 and to further analyze the impact of syphilis serologic titers on perinatal outcomes and neonatal serologic outcomes. Methods. Syphilis-infected pregnant women reported in Changzhou City from 2015 to 2019 were selected as the study population (data were obtained from the “China Information System for Prevention of Mother-to-child Transmission of AIDS, Syphilis and Hepatitis B.” Demographic characteristics, laboratory tests, and medication were collected to describe adverse pregnancy outcomes and the distribution of non-pale leptospiral antibody titers during pregnancy. Multivariate logistic regression was used to analyze the factors influencing adverse pregnancy outcomes. We also compared differences in syphilis titers among mothers who received different interventions, differences in serologic outcomes of their children, and correlations between them. Results. For mothers with syphilis infection, we found no treatment during pregnancy (OR =1.70) and an initial titer greater than 1 : 8 (OR =2.28) to be risk factors. For treated pregnant women, increasing age (OR =1.08), lack of standardized treatment (OR =1.87), and initial titer greater than 1 : 8 (OR =1.69) were risk factors, while previous parity was a protective factor (OR =0.62). For untreated pregnant women, marital status (OR =2.40) and initial titers greater than 1 : 8 (OR =3.57) were risk factors. There were statistically significant differences ( P < 0.01 ) in serologic titer changes, time to antibody regression, and time to exclusion of syphilis infection in children of pregnant women with syphilis infection after receiving different interventions during pregnancy, but different time distributions of interventions had no effect on these three indicators. Conclusion. Pregnant women with syphilis should actively cooperate with their doctors in the standardized treatment of pregnancy, and doctors should also pay more attention to pregnant women with syphilis whose initial titers are greater than 1 : 8. High-quality prenatal care is a key component in interrupting mother-to-child transmission of syphilis and preventing various adverse pregnancy outcomes. The adaptation of standardized treatment protocols for pregnant women with syphilis in China is a strong proof of the progress of precision medicine.

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Maternal syphilis treatment and pregnancy outcomes: a retrospective study in Jiangxi Province, China

Cited by 21 publications

References 16 publications

Determinants of gestational syphilis among women attending prenatal care programs in the Brazilian Amazon

Determinants of gestational syphilis among women attending prenatal care programs in the Brazilian Amazon

Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study

Analysis of Adverse Pregnancy Outcomes of Pregnant Women with Syphilis and Maternal-Infant Serological Association in Changzhou, China, 2015–2019

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