Syphilis in pregnancy in Tanzania. I. Impact of maternal syphilis on outcome of pregnancy.
To measure the impact of maternal syphilis on pregnancy outcome in the Mwanza Region of Tanzania, 380 previously unscreened pregnant women were recruited into a retrospective cohort at delivery and tested for syphilis. Stillbirth was observed in 18 (25%) of 73 women with high-titer active syphilis (i.e., women with a rapid plasma reagin titer > or = 1 :8 and a positive Treponema pallidum hemagglutination assay or indirect fluorescent treponemal antibody test result), compared with 3 (1%) of 233 uninfected women (risk ratio [RR], 18.1; P<.001). Women with high-titer active syphilis were also at the greatest risk of having low-birth-weight or preterm live births (RR, 3.0 and 6.1, respectively), compared with women with other serological stages of syphilis. Among unscreened women, 51% of stillbirths, 24% of preterm live births, and 17% of all adverse pregnancy outcomes were attributable to maternal syphilis. Syphilis continues to be a major cause of pregnancy loss and adverse pregnancy outcome among women who do not receive antenatal syphilis screening and treatment.
Watson-Jones
Deborah
D
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. deborah.watson-jones@lshtm.ac.uk
Changalucha
John
J
Gumodoka
Balthazar
B
Weiss
Helen
H
Rusizoka
Mary
M
Ndeki
Leonard
L
Whitehouse
Anne
A
Balira
Rebecca
R
Todd
James
J
Ngeleja
Donatila
D
Ross
David
D
Buvé
Anne
A
Hayes
Richard
R
Mabey
David
D
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000382:microbiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D013587:Syphilis / Q000150:complications* / Q000453:epidemiology; D013588:Syphilis Serodiagnosis; D013636:Tanzania / Q000453:epidemiology; D014210:Treponema pallidum / Q000276:immunology