title: Syphilis in pregnancy in Tanzania. I. Impact of maternal syphilis on outcome of pregnancy.
abstract: 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.
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. deborah.watson-jones@lshtm.ac.uk
authors.forename: Deborah
authors.initials: D
authors.lastname: Watson-Jones
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.forename: Balthazar
authors.initials: B
authors.lastname: Gumodoka
authors.forename: Helen
authors.initials: H
authors.lastname: Weiss
authors.forename: Mary
authors.initials: M
authors.lastname: Rusizoka
authors.forename: Leonard
authors.initials: L
authors.lastname: Ndeki
authors.forename: Anne
authors.initials: A
authors.lastname: Whitehouse
authors.forename: Rebecca
authors.initials: R
authors.lastname: Balira
authors.forename: James
authors.initials: J
authors.lastname: Todd
authors.forename: Donatila
authors.initials: D
authors.lastname: Ngeleja
authors.forename: David
authors.initials: D
authors.lastname: Ross
authors.forename: Anne
authors.initials: A
authors.lastname: Buvé
authors.forename: Richard
authors.initials: R
authors.lastname: Hayes
authors.forename: David
authors.initials: D
authors.lastname: Mabey
mesh_terms: 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