Symptomatic congenital syphilis in a tertiary neonatal unit in Cape Town, South Africa: High morbidity and mortality in a preventable disease

Pillay, Shakti; Tooke, Lloyd

doi:10.7196/samj.2019.v109i9.13817

Cited by 18 publications

(15 citation statements)

References 22 publications

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“…If these mothers receive treatment during pregnancy, the time for the children to rule out syphilis infection or turn negative for antibody will be shorter; otherwise, the time will be longer, and even congenital syphilis may be finally diagnosed [ 21 , 22 ]. But whether it is one course or two courses, the time distribution of receiving treatment can be different, because our study shows that when the mothers are treated does not affect the children's serological status.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Adverse Pregnancy Outcomes of Pregnant Women with Syphilis and Maternal-Infant Serological Association in Changzhou, China, 2015–2019

Bian

Qin

Zhang

et al. 2022

Stem Cells International

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Background. Although the prevention of mother-to-child transmission of syphilis program in China has achieved national coverage for 7 years, controversy still exists regarding the treatment of syphilis and the serological significance of syphilis. Objective. To explore the occurrence and influencing factors of adverse pregnancy outcomes among pregnant women with syphilis in Changzhou from 2015-2019 and to further analyze the impact of syphilis serologic titers on perinatal outcomes and neonatal serologic outcomes. Methods. Syphilis-infected pregnant women reported in Changzhou City from 2015 to 2019 were selected as the study population (data were obtained from the “China Information System for Prevention of Mother-to-child Transmission of AIDS, Syphilis and Hepatitis B.” Demographic characteristics, laboratory tests, and medication were collected to describe adverse pregnancy outcomes and the distribution of non-pale leptospiral antibody titers during pregnancy. Multivariate logistic regression was used to analyze the factors influencing adverse pregnancy outcomes. We also compared differences in syphilis titers among mothers who received different interventions, differences in serologic outcomes of their children, and correlations between them. Results. For mothers with syphilis infection, we found no treatment during pregnancy (OR =1.70) and an initial titer greater than 1 : 8 (OR =2.28) to be risk factors. For treated pregnant women, increasing age (OR =1.08), lack of standardized treatment (OR =1.87), and initial titer greater than 1 : 8 (OR =1.69) were risk factors, while previous parity was a protective factor (OR =0.62). For untreated pregnant women, marital status (OR =2.40) and initial titers greater than 1 : 8 (OR =3.57) were risk factors. There were statistically significant differences ( P < 0.01 ) in serologic titer changes, time to antibody regression, and time to exclusion of syphilis infection in children of pregnant women with syphilis infection after receiving different interventions during pregnancy, but different time distributions of interventions had no effect on these three indicators. Conclusion. Pregnant women with syphilis should actively cooperate with their doctors in the standardized treatment of pregnancy, and doctors should also pay more attention to pregnant women with syphilis whose initial titers are greater than 1 : 8. High-quality prenatal care is a key component in interrupting mother-to-child transmission of syphilis and preventing various adverse pregnancy outcomes. The adaptation of standardized treatment protocols for pregnant women with syphilis in China is a strong proof of the progress of precision medicine.

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Section: Discussionmentioning

confidence: 99%

Analysis of Adverse Pregnancy Outcomes of Pregnant Women with Syphilis and Maternal-Infant Serological Association in Changzhou, China, 2015–2019

Bian

Qin

Zhang

et al. 2022

Stem Cells International

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“…According to the research by Cooper et al 5 , the eradication of syphilis transmission between mother and fetus depends on the assistance of health services during prenatal care. The consequences of late diagnosis and inadequate treatment of infected newborns can follow severe complications, which affect the central nervous system, bones, joints and teeth 17 . Hence, is imperative the adoption of measures to implement the treatment of congenital syphilis to the newborn, following the guidelines of the Ministry of Health, which were adopted by the maternity where this study was performed , to reduce the damage to a generation exposed to infection with affordable and feasible treatment.…”

Section: Discussionmentioning

confidence: 99%

“…According to the protocol for the prevention of vertical transmission of HIV and Syphilis of the Ministry of Health published in 2007, prenatal care has high coverage in Brazil, a fact found in our study, where 88.7 % of congenital syphilis notifications showed the performance of prenatal care. A research by Cavalcante et al 18 reported that 81.4% of the women received prenatal care during pregnancy 17 . Therefore, if prenatal coverage is adequate, and the incidence of maternal syphilis and congenital syphilis remains high, it is necessary to expand the discussion to the different levels of health care to seek answers and add efforts to control the problem 18 .…”

Section: Discussionmentioning

confidence: 99%

Characterization of congenital syphilis cases with emphasis on the therapeutic scheme in a philanthropic maternity hospital in Espírito Santo

Ferro

Macedo

et al. 2020

jhgd

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Introduction: Syphilis is still a worldwide problem; with approximately 12 million people infected every year. Over the last decade, Brazil had an increment in the number of cases. The year 2016 reported 37,436 cases of syphilis in pregnant women and 20,474 cases of congenital syphilis, with 185 deaths. The Southeast region reached the highest numbers, especially in the state of Espírito Santo with high rates in pregnant women, being the third highest incidence rate in the country with 10.4 cases/1,000 live births, above the national average of 6.8 cases/1,000 live births. Objective: Describe the therapeutic treatment of children affected with congenital syphilis as well as the clinical, radiological and laboratory changes associated to this disease. Methods: Retrospective, descriptive, exploratory, quantitative study, based on 204 notification forms of congenital syphilis from January 2016 to December 2017. Results: The findings showed that 88.7% of the puerperal women performed prenatal care. Regarding newborns, 85.3% were asymptomatic. When analyzing the therapeutic regimen instituted, 22.5% used procaine Penicillin G, 22.5% crystalline Penicillin G and 20.6% benzathine Penicillin G. Conclusion: The treatment instituted by this philanthropic maternity for newborns with congenital syphilis is in line with the guidelines proposed by the Ministry of Health. The clinical symptoms do not represent a frequent finding during the neonatal period, however, they can occur later.

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“…Still, in Cabo, South Africa, a study analyzed 50 newborns with syphilis and showed that, of these, 68% required admission to the intensive care unit and 38% died; it was also found that 56% of mothers did not receive prenatal care due to lack of diagnosis and that 98% of them were treated inadequately (27) .…”

Section: Outcomes In Fetuses and Newborns Exposed To Infections Durin...mentioning

confidence: 99%

“…New PAHO estimates show that, in 661 thousand total cases of congenital syphilis, there were 355 thousand adverse results at birth, which represents a significant relationship between deaths and disease (26) . In regions where syphilis is prevalent in pregnancy, about half the rate of stillbirths may have been caused exclusively by this infection (28) , given that if a pregnant woman is infected and does not receive adequate early treatment for syphilis, she may transmit the infection to the fetus, generating fetal and neonatal complications, such as LBW, premature birth, abortion, and stillbirth (26)(27)(28) .…”

Section: Outcomes In Fetuses and Newborns Exposed To Infections Durin...mentioning

confidence: 99%

Desfechos em fetos e recém-nascidos expostos a infecções na gravidez

et al. 2021

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Objective: To analyze outcomes in fetuses and newborns exposed to infections during pregnancy. Methods: Cross-sectional, quantitative study, carried out in a public maternity hospital in Maceió, Alagoas, Brazil. The sample consisted of 145 medical records of pregnant women admitted between 2015 and 2018 with possible vertically transmitted infections. Incomplete medical records or those that did not make it possible to describe fetal/neonatal exposure were excluded. The chi-squared test was used to verify the association between variables. Results: A greater occurrence of congenital syphilis was observed (28.8%). There was more than one outcome in the same individual, such as low birth weight (39%), respiratory distress (20.5%), oligohydramnios (20%), congenital malformation and small size for gestational age (10.8%). Maternal infections and the number of prenatal visits revealed an association with fetal/neonatal outcome (p ≤ 0.05). Conclusion: The data obtained indicate the occurrence of unfavorable fetal/neonatal outcomes when related to neonatal infections and indicate the need for strategies that strengthen the coping with vertical transmissions.

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Symptomatic congenital syphilis in a tertiary neonatal unit in Cape Town, South Africa: High morbidity and mortality in a preventable disease

Cited by 18 publications

References 22 publications

Analysis of Adverse Pregnancy Outcomes of Pregnant Women with Syphilis and Maternal-Infant Serological Association in Changzhou, China, 2015–2019

Analysis of Adverse Pregnancy Outcomes of Pregnant Women with Syphilis and Maternal-Infant Serological Association in Changzhou, China, 2015–2019

Characterization of congenital syphilis cases with emphasis on the therapeutic scheme in a philanthropic maternity hospital in Espírito Santo

Desfechos em fetos e recém-nascidos expostos a infecções na gravidez

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