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Effectiveness of treatment to improve pregnancy outcomes among women with syphilis in Zhejiang Province, China
  1. Xiao-Hui Zhang1,
  2. Jian Xu1,
  3. Dan-Qing Chen1,
  4. Li-Fang Guo2,
  5. Li-Qian Qiu1
  1. 1Women's Hospital School of Medicine Zhejiang University, Hangzhou, People's Republic of China
  2. 2Women Hospital of Hang Zhou, Hangzhou, People's Republic of China
  1. Correspondence to Professor Li-Qian Qiu, Department of Women's Health, Women's Hospital School of Medicine Zhejiang University, No. 1 Xueshi Road, Hangzhou, Zhejiang 310006, People's Republic of China; xiaoluzi521{at}


Objectives To determine the effectiveness of treatment in improving pregnancy outcomes among women with syphilis.

Methods This is a retrospective study based on the provincial prevention of mother-to-child transmission of syphilis database. All women with syphilis with singleton pregnancies were recruited. We evaluated their pregnancy outcomes by group-specific analyses according to their treatment time and adequacy.

Results The syphilis prevalence among pregnant women was 0.3% (4214/1 338 739) in Zhejiang Province, China, during 2013–2014, considering all live births and abortions. Women with singleton pregnancies (3767) were included in the study, including live births and stillbirths (≥28 weeks). The treatment coverage for all women with syphilis was 80.2% (3022/3767), and 68.2% (2062/3022) of the women were treated adequately. Of 745 infants born to untreated pregnant women with syphilis, 1.2% manifested pneumonia, 2.7% asphyxia, 1.6% birth defects, 3.8% congenital syphilis (CS), 14.2% were preterm, 10.1% had low birth weight (LBW) and 3.1% experienced perinatal death. The risks of asphyxia (OR=2.7), CS (OR=3.1), preterm birth (OR=1.5), LBW (OR=1.9) and perinatal death (OR=3.1) were much higher in infants born to mothers treated inadequately than from those treated adequately. Moreover, mothers with syphilis who initiated treatment in the third trimester suffered an increased risk for asphyxia (OR=3.0), CS (OR=6.0) and LBW (OR=1.7) compared with those who initiated treatment in the first trimester.

Conclusions Early and adequate treatment could improve the adverse pregnancy outcomes among women with syphilis.


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  • Xiao-Hui Zhang and Jian Xu are equal contributors to this study.

  • Handling editor Jackie A Cassell

  • Contributors X-HZ carried out the statistical analysis and drafted the manuscript; JX and D-QC conceived the study and revised the paper and L-FG helped in data collection and cleaning. L-QQ was responsible for the whole programme. All authors read and approved the final manuscript.

  • Funding This work were funded by “He Sheng Yuan mother and infants health program (2015FYH001)” and “Provincial medical and health science and technology project(2016KYA121)” initiated by National Center for Women and Children's Health, Chinese Center for Disease Control and Health and Family Planning Commission of Zhejiang Province.

  • Competing interests None declared.

  • Ethics approval Ethical clearance was obtained from the Women's Hospital School of Medicine Zhejiang University (2016-0005).

  • Provenance and peer review Not commissioned; externally peer reviewed.