Epidemic Profile of Maternal Syphilis in China in 2013.

Lixia Dou,Yaping Qiao,Fang Wang,Li Song,Qian Wang,Xiaoyan Wang,Jie Qiu,Ailing Wang,Xi Jin,Min Su

doi:10.1155/2016/9194805

Abstract

Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China. Methods. Data were from China's Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis. Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64) and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80) and 3.70 (95% CI 2.36 to 5.80), respectively. Conclusion. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis.

Highlights

Pregnant women with syphilis infection can transmit the infection to their fetus and are at great risk for adverse pregnancy outcomes, such as miscarriage, stillbirth, preterm delivery, neonatal death, or congenital syphilis
Adverse pregnancy outcomes including congenital syphilis can be effectively prevented by universal syphilis screening at an early pregnancy stage and treatment of those infected with penicillin, which can provide immediate benefits to both the infected mother and her fetus/infants
Compared with early treatment for infection (≤14 gestational weeks), treatment initiated during 29–37 weeks and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis

Summary

Introduction

Pregnant women with syphilis infection can transmit the infection to their fetus and are at great risk for adverse pregnancy outcomes, such as miscarriage, stillbirth, preterm delivery, neonatal death, or congenital syphilis. Adverse pregnancy outcomes including congenital syphilis can be effectively prevented by universal syphilis screening at an early pregnancy stage and treatment of those infected with penicillin, which can provide immediate benefits to both the infected mother and her fetus/infants. These interventions have been proved to be cost-effective, inexpensive, and feasible. It is reported that congenital syphilis has increased dramatically from 0.01 cases per 100 000 live births in 1991 to 69.9 cases per 100 000 live births in 2013, according to China’s national sexually transmitted disease surveillance system [3, 4]

Methods

Results

Discussion

Conclusion