Prevention and treatment of mother-to-child transmission of syphilis

Serena Braccio, Mike Sharland, Shamez Ladhani*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

20 Citations (Scopus)

Abstract

Purpose of review Athough more than 90% of syphilis cases are diagnosed in developing countries, syphilis rates in industrialized countries have been increasing since the 1980s. Untreated syphilis in pregnancy is associated with high rates of adverse pregnancy outcomes, including fetal loss, premature birth, congenital syphilis, and neonatal death. We reviewed the recent literature on adverse pregnancy outcomes associated with untreated syphilis and the benefits of early and effective treatment. Recent findings Up to two-thirds of pregnant women with untreated syphilis may develop unwanted complications compared with a background rate of 14% in pregnant women without syphilis. A review of interventions to screen and manage infections during pregnancy found that those focusing on syphilis demonstrated an 80% reduction in stillbirths as compared with strategies to treat, detect, or prevent other infections in pregnancy, such as malaria (22% reduction), HIV (7% reduction) or bacterial vaginosis (12% reduction). Detection and treatment of syphilis before the third trimester (28 weeks) can revert the risk of adverse outcomes to background rates. Summary Transplacental transmission of syphilis, especially in the third trimester, is associated with high rates of adverse outcomes, but the risk can be significantly reduced with early detection and treatment in the first and second trimesters, along with careful management of the infant after birth.

Original languageEnglish
Pages (from-to)268-274
Number of pages7
JournalCurrent Opinion in Infectious Diseases
Volume29
Issue number3
DOIs
Publication statusPublished - 1 Jun 2016

Bibliographical note

Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • child health
  • congenital
  • pregnancy outcome
  • prenatal care
  • prenatal diagnosis
  • syphilis

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