Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis
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TLDR
Untreated maternal syphilis is associated with adverse pregnancy outcomes and these findings can inform policy decisions on resource allocation for the detection of syphilis and its timely treatment in pregnant women.Abstract:
OBJECTIVE: To perform a systematic review and meta-analysis of reported estimates of adverse pregnancy outcomes among untreated women with syphilis and women without syphilis. METHODS: PubMed, EMBASE and Cochrane Libraries were searched for literature assessing adverse pregnancy outcomes among untreated women with seroreactivity for Treponema pallidum infection and non-seroreactive women. Adverse pregnancy outcomes were fetal loss or stillbirth, neonatal death, prematurity or low birth weight, clinical evidence of syphilis and infant death. Random-effects meta-analyses were used to calculate pooled estimates of adverse pregnancy outcomes and, where appropriate, heterogeneity was explored in group-specific analyses. FINDINGS: Of the 3258 citations identified, only six, all case-control studies, were included in the analysis. Pooled estimates showed that among untreated pregnant women with syphilis, fetal loss and stillbirth were 21% more frequent, neonatal deaths were 9.3% more frequent and prematurity or low birth weight were 5.8% more frequent than among women without syphilis. Of the infants of mothers with untreated syphilis, 15% had clinical evidence of congenital syphilis. The single study that estimated infant death showed a 10% higher frequency among infants of mothers with syphilis. Substantial heterogeneity was found across studies in the estimates of all adverse outcomes for both women with syphilis (66.5% [95% confidence interval, CI: 58.0-74.1]; I(2) = 91.8%; P < 0.001) and women without syphilis (14.3% [95% CI: 11.8-17.2]; I(2) = 95.9%; P < 0.001). CONCLUSION: Untreated maternal syphilis is associated with adverse pregnancy outcomes. These findings can inform policy decisions on resource allocation for the detection of syphilis and its timely treatment in pregnant women.read more
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Addressing the crisis of congenital syphilis: Key findings from an evaluation of the management of syphilis in pregnancy and the newborn in South-East Queensland.
Mandy Wu,Mandy Wu,Mandy Seel,Sumudu Britton,Sumudu Britton,Judith Dean,Mattea Lazarou,Huda Safa,Paul Griffin,Clare Nourse,Clare Nourse +10 more
TL;DR: Syphilis in pregnancy and congenital syphilis in Australia are increasing in Australia and prevention of adverse outcomes requires adherence to management guidelines.
Journal ArticleDOI
Brazilian Protocol for Sexually Transmitted Infections 2020: acquired syphilis
Francisca Lidiane Sampaio Freitas,Adele Schwartz Benzaken,Mauro Romero Leal Passos,Ivo Castelo Branco Coelho,Angélica Espinosa Barbosa Miranda +4 more
TL;DR: The Clinical Protocol and Therapeutic Guidelines for Comprehensive Care of People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020, includes updates concerning acquired syphilis.
Journal ArticleDOI
Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: sífilis adquirida
Francisca Lidiane Sampaio Freitas,Adele Schwartz Benzaken,Mauro Romero Leal Passos,Ivo Castelo Branco Coelho,Angélica Espinosa Barbosa Miranda +4 more
TL;DR: The Protocolo Clinico e Diretrizes Terapeuticas for Atencao Integral as Pessoas com Infeccoes Sexualmente Transmissiveis, publicado by the Ministerio da Saude do Brazil em 2020, contempla a atualizacao sobre sifilis adquirida.
Journal ArticleDOI
Cost-Effectiveness Analysis of Point-of-Care Rapid Testing Versus Laboratory-Based Testing for Antenatal Screening of Syphilis in Brazil
Carmen Romero,Daniel Savignon Marinho,Rodolfo Castro,Claudia Cristina de Aguiar Pereira,Everton Nunes da Silva,Rosângela Caetano,Flávia Tavares Silva Elias,Jim Chilcott,Simon Dixon +8 more
TL;DR: In Brazil, antenatal screening with syphilis RT and immediate treatment of positive mothers immediately compared with a laboratory-based standard test with treatment at next follow-up visit is likely to be cost-effective compared with standard screening and must be prioritized in local settings.
Journal ArticleDOI
Repeat screening for syphilis in pregnancy as an alternative screening strategy in the UK: A cost-effectiveness analysis
Susie E Huntington,Georgie Weston,Farah Seedat,John Marshall,Heather Bailey,Marc Tebruegge,Imtyaz Ahmed,Katy Turner,Elisabeth J Adams +8 more
TL;DR: Universal repeat screening for syphilis in pregnancy is unlikely to be cost-effective in the current UK setting where syphilis prevalence is low, but repeat screening may be cost -effective in countries with a higher syphilis incidence in pregnancy, particularly if the cost per screen is low.
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Systematic Reviews in Health Care : Meta-Analysis in Context
TL;DR: The second edition of this best-selling book has been thoroughly revised and expanded to reflect the significant changes and advances made in systematic reviewing.