Syphilis in pregnancy in Tanzania. I. Impact of maternal syphilis on outcome of pregnancy
Watson-Jones, D.; Changalucha, J.; Gumodoka, B.; Weiss, H.; Rusizoka, M.; Ndeki, L.; Whitehouse, A.; Balira, R.; Todd, J.; Ngeleja, D.; Ross, D.; Buvé, A.; Hayes, R.; Mabey, D.
Journal of Infectious Diseases 186(7): 940-947
2002
ISSN/ISBN: 0022-1899 PMID: 12232834 DOI: 10.1086/342952Document Number: 245360
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.