Epidemic Profile of Maternal Syphilis in China in 2013

Abstract

Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China. Methods. Data were from China's Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis. Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64) and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80) and 3.70 (95% CI 2.36 to 5.80), respectively. Conclusion. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis.

Gestational and congenital syphilis: maternal, neonatal characteristics and outcome of cases

“…It should be noted that the early initiation of prenatal care and the guarantee of the minimum number of queries are associated with greater suitability of e control actions regarding syphilis, 21 and conversely are factors associated with the occurrence of vertical transmission. 15,17 Cohort study conducted in China pointed out that when the treatment occurs between the 13 to 24 weeks, only 1.6% of infants are infected, and that every week of delay in the treatment increases the risk of congenital syphilis in 12.7%, 1 being that a favorable aspect to women in this study, once 73.5% of them were diagnosed in the first trimester of pregnancy. In addition to the timely detection of syphilis, the access to treatment for pregnant women and their partners is imperative.…”

“…1,8,10,[14][15][16] The identified proportion of gestational syphilis (1.39%) is also above the national prevalence (1.02%), as well assouthern Brazil prevalence (1.10%), 17 which reinforces the need to strengthen epidemiological surveillance in all points of the network, actions thatadd up to the national agenda, as already determined by the Health Pact in 2006. 10 Even with the acknowledged efficacy of diagnosis, treatment and prevention of transmission, 5 the proportion of pregnant women infected with syphilis without therapeutic actions and intervention on risk factors remains high, resulting in abortion, prematurity, neonatal deathand congenital malformations.…”

“…[8][9][10][11][12][13][14][15][16][17][18]19 In this regard, it was found that the majority of pregnant women (55%) studied did only oneVDRL test, indicating non-compliance with the Protocol of attention to prenatal care.…”

“…Other studies also point out lack of follow-up on the VDRL test during pregnancy. 15,17,21 According to PAHO, 94% of pregnant women in the Americas had at least one prenatal consultation during pregnancy and 80% received testing for syphilis at some point in pregnancy. 7 In Brazil, a study with 23,894 postpartum women identified that 98.7% held at least one prenatal consultation and 89% had at least one test records of syphilis, but only 41% conducted the second serological test, 14 data that corroborate the present study findings and imply actions aimed at early detection of syphilis Syphilis: maternal, neonatal characteristics and outcome of cases during pregnancy by means of carrying out the examinations in the correct frequency.…”

Maternal syphilis treatment and pregnancy outcomes: a retrospective study in Jiangxi Province, China

“…Surveillance of maternal syphilis is conducted through mandatory casereporting by all health facilities providing delivery services. Detail information about this system was available elsewhere (5). The regional program was established in 2011.…”