Adverse pregnancy outcomes among women with syphilis in Zhejiang province, 2013-2014.

Abstract

Objective To investigate the incidence of adverse pregnancy outcomes among women with syphilis in Zhejiang province during 2013-2014, and to explore the influence of anti-syphilis treatment on pregnancy outcomes. Methods A retrospective study was carried out according to the Information Management System for preventing mother-to-child transmission(PMTCT)of syphilis in Zhejiang province during 2013-2014. The incidence of adverse pregnancy outcomes was compared between women with syphilis and general women without syphilis, between treated and untreated women with syphilis, as well as between women with syphilis receiving and not receiving standard anti-syphilis treatment. The effects of anti-syphilis treatment and standard anti-syphilis treatment on pregnancy outcomes were analyzed. Results Data were collected from 3 985 women with syphilis and their children. Of these women, 12 had a stillbirth, and 3 973 a live birth. Totally, 3 210(80.55%)women received anti-syphilis treatment, 967(30.12%, 967/3 210)women received substandard treatment, and 775(19.45%)did not receive anti-syphilis treatment. Of the 3 985 fetuses or neonates born to women with syphilis, 45(1.13%)had abnormal clinical symptoms/signs. The incidence rates of low birth weight and early neonatal death were 7.00%(279/3 985)and 1.13%(45/3 985)respectively in fetuses or neonates born to women with syphilis, both significantly higher than those in fetuses or neonates born to general women without syphilis(3.18%[26 092/819494]and 0.13%[1 029/819 494], respectively, both P < 0.01). Among 775 untreated women with syphilis, the incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs were 15.61%(121/775), 10.84%(84/775), 2.45%(19/775), 3.48%(27/775)and 2.84%(22/775)respectively, all significantly higher than those in 3 210 women receiving anti-syphilis therapy(8.26%, 6.07%, 0.81%, 0.81% and 1.03%, respectively, all P < 0.01). Besides, the 967 women receiving substandard anti-syphilis treatment showed higher incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs than the 2 243 women receiving standard treatment(10.44% vs. 7.31%, 8.17% vs. 5.17%, 1.55% vs. 0.49%, 1.65% vs. 0.45%, 1.96% vs. 0.62%, respectively, all P < 0.01). Conclusions The incidence of adverse pregnancy outcomes is high among women with syphilis in Zhejiang province during 2013-2014. Untreated and inadequately treated maternal syphilis is strongly associated with adverse pregnancy outcomes. Key words: Syphilis; Pregnancy outcome; Syphilis, congenital