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Syphilis treatment in mothers crucial to preventing congenital infection
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Early treatment of syphilis in pregnant women is paramount to preventing congenital transmission to fetuses, according to researchers.
A course of benzathine penicillin G (BPG) before the 28th week of gestation is effective in preventing infection, Fu-Chang Hong, MD, of the Shenzhen Center for Chronic Disease Control in China, and colleagues wrote in Clinical Infectious Diseases.
“Undergoing early syphilis screening tests at the first antenatal visit of pregnancy, followed by prompt and adequate treatment of seropositive women with BPG, is at the center of congenital syphilis prevention,” they said.
The researchers gathered data from China’s National Integrated Program for Prevention of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B. They identified 3,519 infants born in Shenzhen City, in Guangdong Province, to women who were diagnosed with syphilis during their pregnancies.
Of those infants, 159 (4.52%) had congenital syphilis. Six were born to women who had received BPG before 28 weeks’ gestation (early BPG), 11 to those who received it at or after 28 weeks’ gestation (late BPG), one to a woman who had received a different antibiotic and 141 to women who had received no syphilis treatment.
The incidence of congenital syphilis ranged from 1.82% to 11.9% lower for infants whose mothers received early BPG compared with those whose mothers had late BPG (adjusted OR 8.06, P < .001), received another antibiotic (aOR 7.71, P = .068) and received no treatment (aOR 68.28, P < .001).
The researchers estimated that 12.23 per 100 infants born to women with untreated syphilis were congenitally infected with the disease.
Women were more likely to forego or miss syphilis treatment if they had only a primary school education or less (aOR 1.5), were Shenzhen residents (aOR 1.38), received antenatal care in less developed districts (OR 1.62), had their first antenatal care visit at 28 gestational weeks or after (aOR 21.47), had HIV (aOR 4.01) or were treated for syphilis before pregnancy (aOR 1.65).
The researchers said the data could shape the way clinicians address potential syphilis infection in pregnant patients.
“These findings are expected to be used as evidence for guiding our practice to prevent mother-to-child transmission of syphilis and for updating the WHO–developed tools for estimating the disease burden of adverse pregnancy outcomes due to maternal syphilis,” they concluded. – by Joe Green
Disclosure: The authors report no relevant financial disclosures.
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