Abstract
Objective:
To evaluate the maternal–fetal management and follow-up of infants at risk for congenital syphilis.
Study Design:
Monocentric retrospective cohort study at the Félix Guyon Hospital, Saint-Denis, La Réunion between January 2008 and December 2014. Management of 38 pregnancies (35 women, 39 fetuses) with a positive syphilis serology was evaluated according to the Centers for Disease Control and Prevention (CDC) guidelines.
Results:
A total of 68% (n=26) of pregnancies were screened before 16 weeks of gestation, and 26% (n=10) had appropriate treatment. Adverse outcomes were noted in 45% of pregnancies. Neonatal serology was not performed in 7 live-born neonates (19%) and 33 infants were classifiable according to the four CDC scenarios. In the infants, adequate complementary evaluation and appropriate treatment were noted in 42% (n=13) and 55% (n=17) of cases, respectively. Rate of infant follow-up was 76% (n=16). No treatment failure was observed in infants.
Conclusion:
Reinforcement of public health policies and a better sensitization, training and collaboration among perinatal caregivers are warranted given the gaps revealed in our study.
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References
Centers for Disease Control and Prevention Centers for Disease Control and Prevention, Patton ME Centers for Disease Control and Prevention, Su JR Centers for Disease Control and Prevention, Nelson R Centers for Disease Control and Prevention, Weinstock H . Primary and secondary syphilis—United States, 2005-2013. MMWR Morb Mortal Wkly Rep 2014; 63 (18): 402–406.
European Centre for Disease Prevention and Control Sexually Transmitted Infections in Europe 2013. ECDC: Stockholm :2015.
Bouyssou A, Janier M, Dupin N, Alcaraz I, Vernay-Vaisse C, Basselier B et al. La syphilis en France : analyse des données de surveillance sur 10 ans, 2000-2009. Bull Epidemiol Hebd 2011; (26-27-28: 295–298.
Bowen V, Su J, Torrone E, Kidd S, Weinstock H . Increase in incidence of congenital syphilis - United States, 2012-2014. MMWR Morb Mortal Wkly Rep 2015; 64 (44): 1241–1245.
Saloojee H, Velaphi S, Goga Y, Afadapa N, Steen R, Lincetto O . The prevention and management of congenital syphilis: an overview and recommendations. Bull World Health Organ 2004; 82 (6): 424–430.
Hawkes S, Matin N, Broutet N, Low N . Effectiveness of interventions to improve screening for syphilis in pregnancy: a systematic review and meta-analysis. Lancet Infect Dis 2011; 11 (9): 684–691.
Renault P, Boidin E, D’Ortenzio E, Balleydier E, Filleul L . Recrudescence de la syphilis à La Réunion: résultats d’une enquête rétrospective 2004-2008. BVS 2010; 6: 2–7.
Ramiandrisoa J, Aubert L, Lespine EB, Alessandri JL, Robillard PY, Bertsch M et al. Congenital syphilis, Réunion Island, 2010. Emerg Infect Dis 2011; 17 (11): 2082–2083.
Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR Morb Mortal Wkly Rep 2006; 55 (11): 22–33.
HAS. Recommandations en santé publique. Evaluation a priori du dépistage de la syphilis en France, mai 2007. Available at http://www.has-sante.fr.
Gomez GB, Kamb ML, Newman LM, Mark J, Broutet N, Hawkes SJ . Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ 2013; 91 (3): 217–226.
Mise à jour des courbes de morphométrie néonatale. Available at http://www.audipog.net/courbes_morpho.php. Published 6 February 2008. Accessed 2 January 2016.
Schmid G . Economic and programmatic aspects of congenital syphilis prevention. Bull World Health Organ 2004; 82 (6): 402–409.
Herremans T, Kortbeek L, Notermans DW . A review of diagnostic tests for congenital syphilis in newborns. Eur J Clin Microbiol Infect Dis 2010; 29 (5): 495–501.
Giraudon I, Forde J, Maguire H, Arnold J, Permalloo N . Antenatal screening and prevalence of infection: surveillance in London, 2000-2007. Euro Surveill 2009; 14: 8–12.
Tridapalli E, Capretti MG, Reggiani ML, Stronati M, Faldella G . Congenital syphilis in Italy: a multicentre study; Italian Neonatal Task Force of Congenital Syphilis for The Italian Society of Neonatology–Collaborative Group. Arch Dis Child Fetal Neonatal 2012; 97 (3): F211–F213.
Kingston M, French P, Higgins S, McQuillan O, Sukthankar A, Stott C et al. UK national guidelines on the management of syphilis. Int J STD AIDS 2015; 27 (6): 421–446.
Shiber L, Todia WJ . Cost and clinical utility of repeated syphilis screening in the third trimester in a high-risk population. Am J Obstet Gynecol 2014; 210 (3): 267.e1–5.
Kiss H, Widhalm A, Geusau A, Husslein P . Universal antenatal screening for syphilis: is it still justified economically? A 10-year retrospective analysis. Eur J Obstet Gynecol Reprod Biol 2004; 112 (1): 24–28.
Singh AE, Romanowski B . Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. Clin Microbiol Rev 1999; 12 (2): 187–209.
Goldenberg RL, Thompson C . The infectious origins of stillbirth. Am J Obstet Gynecol 2003; 189 (3): 861–873.
Walker GJ, Walker DG . Congenital syphilis: a continuing but neglected problem. Semin Fetal Neonatal Med 2007; 12 (3): 198–206.
Sothinathan U, Hannam S, Fowler A, Zuckerman M, Reeves I, Tenant-Flowers M . Detection and follow up of infants at risk of congenital syphilis. Arch Dis Child 2006; 91 (7): 620.
Centers for Disease Control and Prevention. Congenital syphilis - United States, 2003-2008. MMWR Morb Mortal Wkly Rep 2010; 59 (14): 413–417.
Qin JB, Feng TJ, Yang TB, Hong FC, Lan LN, Zhang CL . Maternal and paternal factors associated with congenital syphilis in Shenzhen, China: a prospective cohort study. Eur J Clin Microbiol Infect Dis 2014; 33 (2): 221–232.
Cross A, Luck S, Patey R, Sharland M, Rice P, Chakraborty R . Syphilis in London circa 2004: new challenges from an old disease. Arch Dis Child 2005; 90 (10): 1045–1046.
Hawkes SJ, Gomez GB, Broutet N . Early antenatal care: does it make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis. PLoS One 2013; 8 (2): e56713.
Zhu L, Qin M, Du L, Xie RH, Wong T, Wen SW . Maternal and congenital syphilis in Shanghai, China, 2002 to 2006. Int J Infect Dis 2010; 14 (Suppl 3): e45–e48.
Hollier LM, Harstad TW, Sanchez PJ, Twickler DM, Wendel GD Jr . Fetal syphilis: clinical and laboratory characteristics. Obstet Gynecol 2001; 97 (6): 947–953.
Rodríguez-Cerdeira C, Silami-Lopes VG . Congenital syphilis in the 21st century. Actas Dermosifiliogr 2012; 103 (8): 679–693.
Sánchez PJ, Wendel GD, Norgard MV . IgM antibody to Treponema pallidum in cerebrospinal fluid of infants with congenital syphilis. Am J Dis Child 1992; 146 (10): 1171–1175.
Beeram MR, Chopde N, Dawood Y, Siriboe S, Abedin M . Lumbar puncture in the evaluation of possible asymptomatic congenital syphilis in neonates. J Pediatr 1996; 128 (1): 125–129.
Alexander JM, Sheffield JS, Sanchez PJ, Mayfield J, Wendel GD Jr . Efficacy of treatment for syphilis in pregnancy. Obstet Gynecol 1999; 93 (1): 5–8.
Radcliffe M, Meyer M, Roditi D, Malan A . Single-dose benzathine penicillin in infants at risk of congenital syphilis—results of a randomised study. S Afr Med J 1997; 87 (1): 62–65.
Paryani SG, Vaughn AJ, Crosby M, Lawrence S . Treatment of asymptomatic congenital syphilis: benzathine versus procaine penicillin G therapy. J Pediatr 1994; 125 (3): 471–475.
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Le Chevalier de Préville, M., Alessandri, JL., Traversier, N. et al. Evaluation of the management of pregnancies and infants at risk for congenital syphilis: La Réunion, 2008 to 2014. J Perinatol 37, 116–121 (2017). https://doi.org/10.1038/jp.2016.158
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DOI: https://doi.org/10.1038/jp.2016.158
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