620 Syphilis infection during pregnancy: an essential contributor to adverse pregnancy and neonatal outcomes

Abstract

To determine whether syphilis infection in pregnancy is associated with adverse pregnancy and neonatal outcomes. Retrospective analysis of the Centers for Disease Control and Prevention, Natality Live Birth database (2016-2018). Adverse pregnancy and neonatal outcomes were compared between births diagnosed with syphilis during pregnancy (syphilis group) and those without syphilis (no syphilis group), using Pearson’s Chi-square test with Bonferroni adjustments. Multivariate logistic regression was used to adjust outcomes for potential confounders such as maternal age, body mass index, race/ethnicity, and prior preterm birth (PTB). Results were presented as adjusted Odds Ratios (aOR) with 95% confidence intervals (CI). Statistical significance was set as a P value < 0.05. Infection with syphilis complicated 0.1% (10,215 of 10,426,235) of US live births in 2016-1028. The rates of adverse pregnancy and neonatal outcomes in both groups are displayed in table 1. Syphilis was associated with several adverse pregnancy and neonatal outcomes, including a significantly increased risk for PTB (<37 weeks and<32 weeks), low birthweight, congenital malformations, low 5 minute APGAR scores, NICU admissions, antibiotic treatment of the neonate, immediate ventilation, as well as prolonged ventilation (Table 2). Based on this large US population cohort, syphilis infection during pregnancy is associated with a significant risk for several adverse pregnancy and neonatal outcomes, as well as congenital malformations. Improved strategies for infection prevention, access to timely screening and treatment are essential in order to reduce these adverse pregnancy and neonatal outcomes. The CDC reported recently on the rise in sexually transmitted diseases (STD) during the COVID-19 pandemic. Recent changes in prenatal care related to COVID-19, including fewer prenatal visits, and replacements with telemedicine further challenge the implementation of STD screening and treatment strategies to improve prenatal outcome.View Large Image Figure ViewerDownload Hi-res image Download (PPT)