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Incidence and associated predictors of adverse pregnancy outcomes of maternal syphilis in China, 2016–19: a Cox regression analysis
Author(s) -
Li Z,
Wang Q,
Qiao Y,
Wang X,
Jin X,
Wang A
Publication year - 2021
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.16554
Subject(s) - medicine , syphilis , incidence (geometry) , proportional hazards model , pregnancy , population , obstetrics , hazard ratio , environmental health , confidence interval , family medicine , physics , human immunodeficiency virus (hiv) , biology , optics , genetics
Objective This study aimed to investigate the incidence and associated predictors of adverse pregnancy outcomes (APOs) among pregnant women infected with syphilis. Design Cox regression analysis. Setting China. Population or sample Pregnant women who were tested for and diagnosed with syphilis during the index pregnancy and delivered at a gestational age ≥28 weeks between 2016 and 2019. Methods Data were extracted from China’s Information System of Prevention of Mother‐to‐Child Transmission of Syphilis Management. Descriptive analysis provided profiles and pregnancy outcomes of maternal syphilis, as well as the incidence of APOs. Log‐rank tests and Cox proportional hazard models were used to investigate factors influencing APOs in infected mothers with singleton births. Main outcome measures The incidence of APOs and the hazard ratios of associated predictors using Cox proportional hazard model. Results Syphilis treatment data were available from 83.86% of diagnosed women. Including deliveries from the total study population, 13.33% experienced APOs. Cox regression indicated that APOs were more likely in women tested and diagnosed in the late trimester, at delivery or postpartum. Women who accepted non‐standardised treatment and who received standardised treatment had less risk of APOs. Conclusions China has made huge progress over the last decades in the prevention of mother‐to‐child transmission of syphilis, but the incidence of APOs among pregnant women infected with syphilis remains high. It is essential to further strengthen access to early detection and standardised treatment of infected women to reduce the risk of APOs. Tweetable abstract Access to early detection and standardised treatment reduces the risk of APOs due to maternal syphilis.