title: Barriers to prenatal care and poor pregnancy outcomes among women with syphilis in the Russian Federation.
abstract: We studied predictors of no prenatal care (PNC) and influence of no PNC on pregnancy outcome in a multisite study of 1071 women with syphilis in Russia. We assessed PNC utilization, HIV testing, syphilis treatment, and pregnancy outcome. We found that 37% of women with syphilis received no PNC, and 1% was HIV infected. Lacking official residency status was independently related to no PNC (adjusted odds ratio [AOR]: 8.1; 95% confidence intervals [CI]: 5.3-12.3). Among women with inadequately treated current syphilis, those without PNC were more likely to have a stillborn infant than those with PNC (25% vs. 3%, odds ratio [OR] 9.5, 95% CI 4.0-23.5). Women with adequately treated current syphilis and no PNC were more likely to deliver a low birth weight (OR 3.8; 95% CI 1.8-8.1) or preterm infant (OR 3.9; 95%CI 1.8-8.7). Women with previous or current syphilis and no PNC were significantly more likely to abandon their infants.
authors.affiliation: NY State Department of Health, Metropolitan Regional Area Office, Bureau of Communicable Disease Control, 145 Huguenot Street, Suite 500, New Rochelle, NY 10801, USA. kis08@health.state.ny.us
authors.forename: K L
authors.initials: KL
authors.lastname: Southwick
authors.forename: L I
authors.initials: LI
authors.lastname: Tikhonova
authors.forename: E G
authors.initials: EG
authors.lastname: Salakhov
authors.forename: A
authors.initials: A
authors.lastname: Shakarishvili
authors.forename: C
authors.initials: C
authors.lastname: Ryan
authors.forename: S
authors.initials: S
authors.lastname: Hillis
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000191:economics / Q000382:microbiology / Q000628:therapy*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors; D012426:Russia; D013587:Syphilis / Q000191:economics / Q000517:prevention & control / Q000628:therapy / Q000635:transmission*