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.

In Russia, maternal risk factors and perinatal consequences for epidemiologic cases of CS resembled those of clinical cases. Expanding national reporting to include epidemiologic cases would strengthen CS prevention and monitoring.