Li et al evaluated adverse pregnancy outcomes in pregnant women with syphilis in China. The authors are from the National Centre for Women and Children Health in Beijing.
Patient selection: pregnant woman with syphilis
Adverse pregnancy outcomes:
(1) stillbirth
(2) preterm birth
(3) neonatal death
(4) congenital syphilis
Criteria for congenital syphilis - one or more of the following:
(1) direct visualization of T. pallidum in a clinical specimen (dark field, other)
(2) IgM-positive reactive treponemal antibody test
(3) positive treponemal test in neonate AND titer of non-treponemal test (RPR, TRUST) >= 4 times higher than that of the mother before delivery
Predictors of adverse pregnancy outcomes on multivariate analysis:
(1) diagnosis at any time after first trimester (HR 4.1 in second trimester and 26.7 postpartum)
(2) coinfection with HBV (HR 2.4)
(3) not accepting standardized or non-standardized treatment
