Incidence of Congenital Syphilis and Adverse Pregnancy Outcomes among Syphilitic Pregnant Women According to the Treatment Adequacy in Tertiary Care Hospital, Thailand
Jiraporn Luengmettakul¹, Suttanaratt Apiwantana¹, Nattapong Jitrungruengnij²
Affiliation : ¹ Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Charoenkrung Pracharak Hospital, Division of Medical Service, Bangkok Metropolitan Administration, Bangkok, Thailand; ² Department of Pediatrics, Charoenkrung Pracharak Hospital, Division of Medical Service, Bangkok Metropolitan Administration, Bangkok, Thailand
Objective: To investigate the incidence of congenital syphilis and adverse pregnancy outcomes between maternal adequate treatment and inadequate treatment.
Materials and Methods: The present study was a retrospective cohort study involving pregnant women who underwent delivery between January 2015 and December 2021. The study included 212 pregnant women with a confirmed syphilis infection. Of these, 106 were in the adequate treatment group and received a full course of penicillin injections at least 30 days prior to delivery, and 106 were in the inadequate treatment group. The authors investigated the incidence of congenital syphilis and adverse pregnancy outcomes according to the adequacy of penicillin treatment.
Results: Between 2015 to 2021, 28,849 pregnant women underwent delivery. The incidence of congenital syphilis was 104 cases per 100,000 live births, and 212 syphilitic pregnant women were enrolled. The mean age for mothers in the adequate group and the inadequate group was 21.87±5.42 and 23.31±5.68, respectively. The inadequate treatment group had a significantly higher rate of congenital syphilis at 28.3% versus 0% (p<0.001), low birth weight of 27.4% versus 15.1% (p=0.031), birth asphyxia at 11.3% versus 0% (p<0.001), late preterm delivery at 18.9% versus 9.4% (p=0.017), and stillbirth at 7.5% versus 0% (p=0.007) than the adequate group. The syphilitic mother who received treatment after 28 weeks’ gestation had a significantly higher risk of congenital syphilis (OR 26.98, 95% CI 3.56 to 204.15) and preterm labor (OR 3.74, 95% CI 1.66 to 8.40) compared to those received treatment before 28 weeks’ gestation.
Conclusion: Adequate penicillin treatment before 28 weeks’ gestation can prevent congenital syphilis and preterm delivery. It is crucial to implement a prevention and control strategy for syphilis before pregnancy, as well as an antenatal care follow-up protocol during pregnancy.
Received 15 July 2024 | Revised 21 November 2024 | Accepted 2 December 2024
DOI: 10.35755/jmedassocthai.2025.1.9-16-01174
Keywords : Adequacy of treatment; Syphilis; Pregnancy; Congenital syphilis
All Articles
Download