Over a million pregnant women infected with syphilis worldwide
Syphilis still affects large numbers of pregnant women worldwide, causing serious health problems and even death to their babies, yet this infection could be prevented by early testing and treatment, according to a study by international researchers published in PLOS Medicine (26 February 2013).
Global estimates of syphilis in pregnancy and associated adverse outcomes: Analysis of multinational antenatal surveillance data
Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis
Early antenatal care: does It make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis
Safety of benzathine penicillin for preventing congenital syphilis: A systematic review
Syphilis testing in pregnancy
Estimate show that in 2008, 1.4 million pregnant women around the world were infected with syphilis, 80% of whom had attended antenatal care services.
The researchers reached this figure by using information on the number of syphilis infections from 97 countries and on antenatal clinic attendance from 147 countries and then inputted this information into a model.
In consultation with experts, the authors used a realistic scenario to estimate the percentage of pregnant women tested for syphilis and adequately treated, ranging from 30% for Africa and the Mediterranean region to 70% for Europe. Based on this scenario, the authors estimate that in 2008, syphilis infections in pregnant women caused approximately 520,000 harmful outcomes, including 215,000 stillbirths, 90,000 neonatal (baby) deaths, 65,000 preterm or low birth-weight babies, and 150,000 babies with congenital infections.
Syphilis continues to be an important cause of adverse outcomes of pregnancy, including substantial numbers of perinatal deaths and disabilities
The authors estimate that in 2008, testing and treating pregnant women for syphilis prevented a quarter of such harmful outcomes but worryingly, the authors found that about two-thirds of these harmful effects occurred in women who had attended antenatal care but were not treated or tested for syphilis. They continue: “Countries also need to ensure that quality-assured syphilis testing is available in all antenatal clinic settings, now possible even in remote care settings with the introduction of rapid point-of-care diagnostics.”
The authors add: “In addition, efforts are needed to ensure universal access to early antenatal care, as well as improved quality of antenatal care so that all pregnant women receive an essential package of services that includes routine and early access to point-of-care testing and adequate treatment for syphilis if seropositive.”