Talk:Abnormal Development - Syphilis
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Cite this page: Hill, M.A. (2024, April 16) Embryology Abnormal Development - Syphilis. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Abnormal_Development_-_Syphilis |
2011
BMC Public Health. 2011 Apr 13;11 Suppl 3:S9.
Blencowe H, Cousens S, Kamb M, Berman S, Lawn JE.
SourceLondon School of Hygiene and Tropical Medicine, London, UK. hblencowe@gmail.com Abstract
BACKGROUND:Globally syphilis is an important yet preventable cause of stillbirth, neonatal mortality and morbidity.OBJECTIVES:This review sought to estimate the effect of detection and treatment of active syphilis in pregnancy with at least 2.4 MU benzathine penicillin (or equivalent) on syphilis-related stillbirths and neonatal mortality.
METHODS:We conducted a systematic literature review of multiple databases to identify relevant studies. Data were abstracted into standardised tables and the quality of evidence was assessed using adapted GRADE criteria. Where appropriate, meta-analyses were undertaken.RESULTS:Moderate quality evidence (3 studies) supports a reduction in the incidence of clinical congenital syphilis of 97% (95% c.i 93 - 98%) with detection and treatment of women with active syphilis in pregnancy with at least 2.4 MU penicillin. The results of meta-analyses suggest that treatment with penicillin is associated with an 82% reduction in stillbirth (95% c.i. 67 - 90%) (8 studies), a 64% reduction in preterm delivery (95% c.i. 53 - 73%) (7 studies) and an 80% reduction in neonatal deaths (95% c.i. 68 - 87%) (5 studies). Although these effect estimates were large and remarkably consistent across studies, few of the studies adjusted for potential confounding factors and thus the overall quality of the evidence was considered low. However, given these large observed effects and a clear biological mechanism for effectiveness the GRADE recommendation is strong.CONCLUSION:Detection and appropriate, timely penicillin treatment is a highly effective intervention to reduce adverse syphilis-related pregnancy outcomes. More research is required to identify the most cost-effective strategies for achieving maximum coverage of screening for all pregnant women, and access to treatment if required.
PMID 21501460
2010
Maternal and congenital syphilis in Shanghai, China, 2002 to 2006
Int J Infect Dis. 2010 Sep;14 Suppl 3:e45-8. Epub 2010 Feb 6.
Zhu L, Qin M, Du L, Xie RH, Wong T, Wen SW.
SourceShanghai First Maternity and Infant Hospital/Tongji University, Shanghai Women's Health Institute, Shanghai, China. AbstractOBJECTIVE:To assess the trends and determinants of maternal and congenital syphilis in Shanghai, China.METHODS:We conducted a prospective cohort study of maternal and congenital syphilis from 2002 to 2006 in Shanghai, China. We presented the trends of maternal syphilis and congenitalsyphilis rates and compared outcomes in infants born to mothers with complete versus incomplete treatment for maternal syphilis. We also assessed the determinants of compliance to treatment of maternal syphilis and examined the associations of initial maternal RPR antibody level and gestational age at initiation of treatment with occurrence of congenital syphilis.RESULTS:A total of 535 537 pregnant women were included in the analysis. During this period of time, 1471 maternal syphilis cases (298.7 per 100 000 live births) and 334 congenitalsyphilis cases (62.4 per 100 000 live births) were identified. Both maternal and congenital syphilis rates increased from 2002 until 2005, with a slight decrease in 2006. The rate of maternalsyphilis was 156.2 per 100 000 live births in Shanghai residents and 371.7 per 100 000 live births in the migrating population (p<0.001). The compliance to treatment for maternal syphiliswas poorer in women with a lower level of education. The rate of congenital syphilis in infants born to mothers with incomplete treatment (50.8%) was much higher than in infants born to mothers with complete treatment (12.5%). Rates of fetal death, neonatal death, and major birth defects were 30.4%, 11.0%, and 3.8%, respectively, in the incomplete treatment group; the corresponding figures were 5.5%, 0.56%, and 0.46%, respectively, in the complete treatment group. Infant outcome was also affected by initial maternal RPR antibody level and time of treatment, with much better outcomes in mothers with low antibody levels and earlier treatment.CONCLUSION:There has been a resurgence of congenital syphilis in Shanghai, China, especially in the migrating population and other populations with a lower socioeconomic status.Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
PMID 20137991
Table 1. Number of notifications of syphilis and congenital syphilis in Australia 2004–2007
