Objective:to evaluate the prevalence of maternal syphilis at delivery and neonatal syphilis infection in an Italian urban area, in connection with the increased flow of immigration.
Study design: A prospective surveillance study was carried out in Bologna, Italy, from November 2000 to March 2006. All pregnant women were screened for syphilis at delivery. Infants born to seropositive mothers were enrolled in a prospective follow-up.
Results: During the study period 19 205 women gave birth to 19 548 infants. A total of 85 women were seropositive for syphilis at delivery. The overall syphilis seroprevalence in pregnant women was 0.44%, but it was 4.3% in women from eastern Europe and 5.8% in women from Central–South America. Ten women were first found positive at delivery, as they did not receive any prenatal care. Nine of these were from eastern Europe. All their infants were asymptomatic, but six had both reactive immunoglobulin (Ig)M western blot and rapid plasma reagin tests and were considered prenatally infected. Three of six were preterm (gestational age <37 weeks).
Conclusions: In Italy, congenital syphilis infection is strictly related to immigration from eastern Europe. Although it is asymptomatic, it could cause premature delivery. Therefore, it is necessary to perform serological tests during the third trimester in mothers coming from endemic areas to adequately treat syphilis in pregnancy and prevent congenital infection. If the mother’s test results are not available at delivery, it is necessary to investigate the newborn, especially if it is born prematurely.
- RPR, rapid plasma reagin
- VDRL, Venereal Disease Research Laboratory
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Competing interests: None declared.
Contributors: ET designed the study plan, organised the multidisciplinary collaboration among the various participants in the study, carried out the clinical follow-up of the infants born to seropositive mothers and contributed to the drawing up of the paper, MGC contributed to designing the study plan, she collected the data and contributed to the drawing up of the paper, VS designed the serological follow-up of the seropositive mothers and their children, AMa carried out the serological follow-up of the participants in the study and contributed to the drawing up of the paper, AMo carried out the serological follow-up of the participants in the study, AD’A carried out the clinical follow-up of the seropositive women attending the centre for sexually transmitted diseases, MLB conducted the statistical analyses of study results, and GF contributed to designing the study plan and the drawing up of the paper and reviewed the paper.
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