The researchers, led by Lori Newman from the World Health Organization, used data on the number of syphilis infections from 97 countries and on antenatal clinic attendance from 147 countries, and inputted this information into a model. They discovered that, in 2008, an estimated 1.4 million pregnant women around the world were infected with syphilis, 80% of whom had attended antenatal care services.
The study authors also consulted experts to estimate the percentage of pregnant women who were adequately tested and treated for syphilis. At the lowest end of the scale were Africa and the Mediterranean region, with just 30%, whilst Europe came out on top with 70%. Based on this scale, the authors calculated that syphilis infections in pregnant women caused approximately 520,000 harmful outcomes in 2008. This included 215,000 stillbirths, 90,000 neonatal (baby) deaths, 65,000 preterm or low birth-weight babies, and 150,000 babies with congenital infections.
The authors surmised that a quarter of such harmful outcomes were prevented in 2008 with testing and treating pregnant women for syphilis, but they also noted that about two-thirds of these harmful effects occurred in women who had attended antenatal care but were not treated or tested for syphilis. They said, ‘This analysis indicates that syphilis continues to be an important cause of adverse outcomes of pregnancy, including substantial numbers of perinatal deaths and disabilities.’
‘Countries also need to ensure that quality-assured syphilis testing is available in all antenatal clinic settings, now possible even in remote care settings with the introduction of rapid point-of-care diagnostics,’ they continued. ‘In addition, efforts are needed to ensure universal access to early antenatal care, as well as improved quality of antenatal care so that all pregnant women receive an essential package of services that includes routine and early access to point-of-care testing and adequate treatment for syphilis if seropositive.’