Treatment evaluation to improve preventing mother to child transmission among women with syphilis

Gong, Ting-Ting; Shao, Yan; Liu, Juning; Wu, Qianlan; Xu, Rongbin; Sun, Liguang; Peng, Xiaoju

doi:10.1038/s41598-019-56095-6

Cited by 10 publications

(11 citation statements)

References 19 publications

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“…Thus, the standardized treatment of gestational syphilis required for sufficient penicillin treatment for 2 courses during the pregnancy and the 2nd course should be conducted and finished at the third trimester. Since the extensive implementation of PMTCT in 2011, except for some developed cities such as Shenzhen 19 , the standardized treatment rates of gestational syphilis are unfavorable in other cities and are only 44.6-65.1% 2,6,20,21 . There is still huge gap from the goal of eliminating mother-to-infant syphilis transmission by 95% set up by Worth Health Organization in 2014 22 .…”

Section: Discussionmentioning

confidence: 99%

Standardized treatment and determinants on 9,059 syphilis-infected pregnant women during 2015–2018 in Hunan, China

Tan

Luo

et al. 2020

Sci Rep

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this study was aimed to describe the standardized treatment rate of syphilis-infected pregnant women in Hunan province and to explore the determinants for standardized treatment. All syphilisinfected pregnant women registered in the Information System of Prevention of Mother-to-Child Transmission of Syphilis Management (IPMTCT) in Hunan between January 2015 and December 2018 were included in this study. Among 9,059 pregnant women with syphilis, 7,797 received syphilis treatment, with a treatment rate of 86.1%, and 4,963 underwent standardized syphilis treatment, with an average standardized treatment rate of 54.8%. The facilitators for the standardized treatment included abnormal reproductive histories (

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Section: Discussionmentioning

confidence: 99%

Standardized treatment and determinants on 9,059 syphilis-infected pregnant women during 2015–2018 in Hunan, China

Tan

Luo

et al. 2020

Sci Rep

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“…Currently, several studies had investigated the associations of treatment during pregnancy with pregnancy outcomes among syphilis infected pregnant women [ 7 – 10 ], mainly concentrated in economically developed areas. Limited data are available to evaluate the influence of maternal treatment on pregnancy outcomes in economically underdeveloped areas, such as Jiangxi Province.…”

Section: Introductionmentioning

confidence: 99%

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

Wan

Zhang

et al. 2020

BMC Pregnancy Childbirth

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Background Studies investigating the associations of maternal syphilis treatment with birth outcomes mainly concentrated in economically developed areas. Limited data are available in economically underdeveloped areas, such as Jiangxi Province. The study aims to investigate the impact of maternal treatment on birth outcomes in Jiangxi Province, China. Methods Data were obtained from the China’s Information System of Prevention of Mother-to-Child Transmission in Jiangxi Province. All syphilis infected pregnant women who delivered ≥28 gestational weeks and were registered in this system between 1 January 2013 and 31 December 2019 were enrolled. Pregnancy outcomes were evaluated by group-specific analyses according to their treatment status, adequacy and initiation time. Results 4210 syphilis infected pregnant women were included in the analyses. Infants born to untreated mothers (n = 1364) were at significantly higher risk for stillbirth (adjusted odds ratio (aOR) = 1.74, 95% CI, 1.01–3.00, P = 0.045), preterm birth (aOR = 1.27, 95% CI, 1.02–1.59, P = 0.034) and low birth weight (LBW) (aOR = 1.44; 95% CI, 1.11–1.86, P = 0.006) than those born to treated mothers (n = 2846) after adjustment for confounding factors. A significantly higher risk of stillbirth (aOR = 3.68; 95% CI, 1.62–8.34, P = 0.002), preterm birth (aOR = 2.26; 95% CI, 1.71–3.00, P < 0.001), LBW (aOR = 2.23; 95% CI, 1.59–3.14, P < 0.001) and congenital syphilis (CS) (aOR = 3.63; 95% CI, 1.80–7.31, P < 0.001) was found in infants exposed to mothers treated inadequately (n = 1299) than those treated adequately (n = 1547). No pregnant women who initiated the treatment in the first trimester (n = 682) delivered a neonatal CS case. Compared with mothers who initiated treatment in the first trimester (n = 682), those initiated in the third trimester (n = 1234) suffered an increased risk of stillbirth (aOR = 4.48; 95% CI, 1.31–15.30, P = 0.017), preterm birth (aOR = 2.34; 95% CI, 1.61–3.40, P < 0.001) and LBW (aOR = 3.25; 95% CI, 1.97–5.37, P < 0.001). Conclusions Maternal treatment, especially early and adequate treatment, plays a crucial role in mitigating adverse pregnancy outcomes among syphilis infected women.

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“…Firstly, despite the high coverage of antenatal care and syphilis testing for pregnant Chinese women, it is estimated that only 80% of pregnant women with positive test of syphilis receive proper treatment, and only 53% complete recommended treatment for syphilis during pregnancy [14] . The main reason is that many pregnant women start to receive antenatal care in the last trimester, which is too late to receive two-course anti-syphilis therapy because the time interval of two-course treatment is at least four weeks.…”

Section: Problems and Difficulties Of Emtct Of Syphilis In Chinamentioning

confidence: 99%

Eliminating Mother-to-Child Transmission of Syphilis: Chinese Practice before and during COVID-19 Pandemics

Du¹,

Zhang²,

Wang³

2022

Chinese Medical Sciences Journal

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Mother-to-child transmission (MTCT) of syphilis remains a leading cause of stillbirth and death among neonates in many developing countries. In 2007, WHO launched the global elimination of MTCT (EMTCT) of syphilis. Given the high burden of congenital syphilis, China subsequently released the specific national EMTCT policies and programs to reduce MTCT of syphilis. The congenital syphilis incidence rate per 100 000 live births in China has markedly decreased from 69.9 in 2013 to 11.9 in 2019. However, due to the global pandemic of COVID-19, the current measures for eliminating MTCT of syphilis are great challenged. In this article, we summarize the strategies and measures for the EMTCT of syphilis in China in the past 20 years, point out that we have made remarkable achievements due to the national health policy support and strong leadership of the government. In the context of COVID-19 pandemics, strengthening emergency response to the regional outbreaks of COVID-19 and adopting safe, rapid, early and high-quality clinical care to ensure that 100% of pregnant women receive prenatal syphilis testing services, ensuring the availability of Benzathine penicillin for the treatment, and strengthening the closedloop management of pregnant women and newborns infected with syphilis are key measures to determine the effect of MTCT of syphilis. Lessons from China may be valuable for other countries that are planning to eliminate MTCT of syphilis.

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Treatment evaluation to improve preventing mother to child transmission among women with syphilis

Cited by 10 publications

References 19 publications

Standardized treatment and determinants on 9,059 syphilis-infected pregnant women during 2015–2018 in Hunan, China

Standardized treatment and determinants on 9,059 syphilis-infected pregnant women during 2015–2018 in Hunan, China

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

Eliminating Mother-to-Child Transmission of Syphilis: Chinese Practice before and during COVID-19 Pandemics

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