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. 2020 Oct 27;20(1):648.
doi: 10.1186/s12884-020-03314-y.

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

Zhihua Wan  1 , Huan Zhang  1 , Haigang Xu  1 , Yang Hu  1 , Cai Tan  1 , Yuling Tao  2
Affiliations

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

Zhihua Wan et al. BMC Pregnancy Childbirth. .

Abstract

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.

Keywords: Congenital syphilis; Maternal treatment; Pregnancy outcomes; Syphilis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study population. This figure demonstrates how the study population was selected
See this image and copyright information in PMC

References

    1. Korenromp EL, Rowley J, Alonso M, Brito de Mello M, Wijesooriya NS, Mahiané SG, et al. Global burden of maternal and congenital syphilis and associated adverse birth outcomes - estimates for 2016 and progress since 2012. PLoS One. 2019;14(2):e0211720. doi: 10.1371/journal.pone.0211720. - DOI - PMC - PubMed
    1. Newman L, Kamb M, Hawkes S, Gomez G, Say L, Seuc A, et al. Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data. PLoS Med. 2013;10(2):e1001396. doi: 10.1371/journal.pmed.1001396. - DOI - PMC - PubMed
    1. Gomez GB, Kamb ML, Newman LM, Mark J, Broutet N, Hawkes SJ. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ. 2013;91(3):217–226. doi: 10.2471/BLT.12.107623. - DOI - PMC - PubMed
    1. Wang AL, Qiao YP, Wang LH, Fang LW, Wang F, Jin X, et al. Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China. Bull World Health Organ. 2015;93(1):52–56. doi: 10.2471/BLT.14.139626. - DOI - PMC - PubMed
    1. Dou L, Wang X, Wang F, Wang Q, Qiao Y, Su M, et al. Epidemic profile of maternal syphilis in China in 2013. Biomed Res Int. 2016;2016:9194805. doi: 10.1155/2016/9194805. - DOI - PMC - PubMed

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