Syphilis Treatment before 28 Weeks of Pregnancy, Critical for Preventing Adverse Outcomes of Syphilis
Syphilis in pregnancy causes stillbirth, neonatal death, prematurity, low birth weight, and congenital syphilis. A recent retrospective study compared the frequency of adverse pregnancy outcomes among syphilis-seropositive women who received different treatment regimens at different times in Guangzhou, China. The results showed that the adverse outcomes were similar between syphilis-seropositive pregnant women who received one or two courses of penicillin treatment. Moreover, the adverse outcomes were more common among women with non-treponemal serum test titers >1:8 who received penicillin treatment after 28 weeks of pregnancy. The findings indicated that one course of penicillin before 28 weeks of pregnancy is critical for preventing adverse outcomes of syphilis. According to study researchers, these findings have important practical implications for the prevention and treatment syphilis- associated adverse pregnancy outcomes and strategies to promote higher-quality, more comprehensive prenatal healthcare services are needed.
The study comprised of 1187 pregnant women with syphilis infection who received prenatal and delivery. Association between treatment status and the composite adverse outcomes (preterm birth, infant smaller than gestational age, stillbirth, and spontaneous abortion) was estimated.
Results showed that 900 (75.8%) syphilis-seropositive pregnant women received treatment, and 287(24.2%) did not receive treatment. In women with treatment, adverse pregnancy outcomes were reported in 16.3% and 33.8% in women without treatment. Risk of adverse pregnancy outcomes was similar in women treated with one or two courses of penicillin (adjusted RR = 1.36). 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). Women whose non-treponemal serum test titer was >1:8 and received treatment after 28 weeks reported adverse compared to before 28 weeks.
BMC Infectious Diseases (2019) 19:292. https://doi.org/10.1186/s12879-019-3896-4