Skip to main content
Top
Published in:

29-12-2023 | Syphilis | Maternal-Fetal Medicine

Associations between maternal syphilis infection during pregnancy and low birth weight and preterm birth: a prospective cohort study

Authors: Mengting Sun, Manjun Luo, Tingting Wang, Taowei Zhong, Qian Chen, Hanjun Liu, Jiapeng Tang, Liuxuan Li, Jiabi Qin

Published in: Archives of Gynecology and Obstetrics | Issue 1/2024

Login to get access

Abstract

Background

In recent years, syphilis is still the most common sexually transmitted disease worldwide. Pregnant women infected with syphilis can transmit it to the fetus in utero through mother-to-child transmission, which can directly lead to adverse pregnancy outcomes. The aim of this study was to investigate the associations between maternal syphilis infection and low birth weight and preterm birth in offspring.

Methods

Multinomial logistic regression model was used to analyze the associations between maternal syphilis infection and low birth weight and preterm birth, and to explore its stability through subgroup analysis.

Results

A total of 34,074 subjects were included in the study. After adjusting for potential confounders, maternal syphilis infection during pregnancy was associated with a 2.60-fold (95% CI 1.83–3.69) increased risk of low birth weight and a 1.91-fold (95% CI 1.35–2.69) increased risk of preterm birth. Subgroup analysis showed that the association was stable.

Conclusion

We found that maternal syphilis infection during pregnancy was significantly associated with an increased risk of low birth weight and preterm birth. The implementation of reasonable syphilis screening and standardized treatment and follow-up of pregnant syphilis may have important practical significance in reducing the low birth weight and preterm birth rate in offspring.
Literature
1.
go back to reference Blencowe H, Krasevec J, de Onis M et al (2019) National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health 7(7):e849–e860CrossRefPubMedPubMedCentral Blencowe H, Krasevec J, de Onis M et al (2019) National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health 7(7):e849–e860CrossRefPubMedPubMedCentral
2.
go back to reference Chawanpaiboon S, Vogel JP, Moller AB et al (2019) Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health 7(1):e37–e46CrossRefPubMed Chawanpaiboon S, Vogel JP, Moller AB et al (2019) Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health 7(1):e37–e46CrossRefPubMed
3.
go back to reference Katz J, Lee AC, Kozuki N et al (2013) Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis. Lancet 382(9890):417–425CrossRefPubMedPubMedCentral Katz J, Lee AC, Kozuki N et al (2013) Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis. Lancet 382(9890):417–425CrossRefPubMedPubMedCentral
5.
go back to reference McGuire S (2015) World Health Organisation. Comprehensive implementation plan on maternal, infant, and young child nutrition. Geneva, Switzerland, 2014. Adv Nutr 6(1):134–135CrossRefPubMedPubMedCentral McGuire S (2015) World Health Organisation. Comprehensive implementation plan on maternal, infant, and young child nutrition. Geneva, Switzerland, 2014. Adv Nutr 6(1):134–135CrossRefPubMedPubMedCentral
6.
go back to reference Korenromp EL, Rowley J, Alonso M et al (2019) Global burden of maternal and congenital syphilis and associated adverse birth outcomes—estimates for 2016 and progress since 2012. PLoS ONE 14(2):e0211720CrossRefPubMedPubMedCentral Korenromp EL, Rowley J, Alonso M et al (2019) Global burden of maternal and congenital syphilis and associated adverse birth outcomes—estimates for 2016 and progress since 2012. PLoS ONE 14(2):e0211720CrossRefPubMedPubMedCentral
7.
go back to reference Wang AL, Qiao YP, Wang LH et al (2015) Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China. Bull World Health Organ 93(1):52–56CrossRefPubMed Wang AL, Qiao YP, Wang LH et al (2015) Integrated prevention of mother-to-child transmission for human immunodeficiency virus, syphilis and hepatitis B virus in China. Bull World Health Organ 93(1):52–56CrossRefPubMed
9.
go back to reference Burton AE, Thomas S (2019) Sexually transmitted infections and preterm birth among indigenous women of the Northern Territory, Australia: a case–control study. Aust N Z J Obstet Gynaecol 59(1):147–153CrossRefPubMed Burton AE, Thomas S (2019) Sexually transmitted infections and preterm birth among indigenous women of the Northern Territory, Australia: a case–control study. Aust N Z J Obstet Gynaecol 59(1):147–153CrossRefPubMed
10.
go back to reference Donders GG, Desmyter J, De Wet DH, Van Assche FA (1993) The association of gonorrhoea and syphilis with premature birth and low birthweight. Genitourin Med 69(2):98–101PubMedPubMedCentral Donders GG, Desmyter J, De Wet DH, Van Assche FA (1993) The association of gonorrhoea and syphilis with premature birth and low birthweight. Genitourin Med 69(2):98–101PubMedPubMedCentral
11.
go back to reference Mann JR, McDermott S, Gill T (2010) Sexually transmitted infection is associated with increased risk of preterm birth in South Carolina women insured by Medicaid. J Matern Fetal Neonatal Med 23(6):563–568CrossRefPubMed Mann JR, McDermott S, Gill T (2010) Sexually transmitted infection is associated with increased risk of preterm birth in South Carolina women insured by Medicaid. J Matern Fetal Neonatal Med 23(6):563–568CrossRefPubMed
12.
go back to reference Qin JB, Feng TJ, Yang TB et al (2014) Synthesized prevention and control of one decade for mother-to-child transmission of syphilis and determinants associated with congenital syphilis and adverse pregnancy outcomes in Shenzhen, South China. Eur J Clin Microbiol Infect Dis 33(12):2183–2198CrossRefPubMed Qin JB, Feng TJ, Yang TB et al (2014) Synthesized prevention and control of one decade for mother-to-child transmission of syphilis and determinants associated with congenital syphilis and adverse pregnancy outcomes in Shenzhen, South China. Eur J Clin Microbiol Infect Dis 33(12):2183–2198CrossRefPubMed
13.
go back to reference (2002) Sexually transmitted diseases treatment guidelines 2002. Centers for Disease Control and Prevention. MMWR Recomm Rep 51(RR-6):1–78 (2002) Sexually transmitted diseases treatment guidelines 2002. Centers for Disease Control and Prevention. MMWR Recomm Rep 51(RR-6):1–78
14.
go back to reference Gao R, Liu B, Yang W et al (2021) Association of maternal sexually transmitted infections with risk of preterm birth in the United States. JAMA Netw Open 4(11):e2133413CrossRefPubMedPubMedCentral Gao R, Liu B, Yang W et al (2021) Association of maternal sexually transmitted infections with risk of preterm birth in the United States. JAMA Netw Open 4(11):e2133413CrossRefPubMedPubMedCentral
15.
go back to reference Hira SK, Bhat GJ, Chikamata DM et al (1990) Syphilis intervention in pregnancy: Zambian demonstration project. Genitourin Med 66(3):159–164PubMedPubMedCentral Hira SK, Bhat GJ, Chikamata DM et al (1990) Syphilis intervention in pregnancy: Zambian demonstration project. Genitourin Med 66(3):159–164PubMedPubMedCentral
16.
go back to reference Watson-Jones D, Changalucha J, Gumodoka B et al (2002) Syphilis in pregnancy in Tanzania. I. Impact of maternal syphilis on outcome of pregnancy. J Infect Dis 186(7):940–947CrossRefPubMed Watson-Jones D, Changalucha J, Gumodoka B et al (2002) Syphilis in pregnancy in Tanzania. I. Impact of maternal syphilis on outcome of pregnancy. J Infect Dis 186(7):940–947CrossRefPubMed
17.
go back to reference Andrews WW, Klebanoff MA, Thom EA et al (2006) Midpregnancy genitourinary tract infection with Chlamydia trachomatis: association with subsequent preterm delivery in women with bacterial vaginosis and Trichomonas vaginalis. Am J Obstet Gynecol 194(2):493–500CrossRefPubMed Andrews WW, Klebanoff MA, Thom EA et al (2006) Midpregnancy genitourinary tract infection with Chlamydia trachomatis: association with subsequent preterm delivery in women with bacterial vaginosis and Trichomonas vaginalis. Am J Obstet Gynecol 194(2):493–500CrossRefPubMed
19.
go back to reference Rac MW, Revell PA, Eppes CS (2017) Syphilis during pregnancy: a preventable threat to maternal-fetal health. Am J Obstet Gynecol 216(4):352–363CrossRefPubMed Rac MW, Revell PA, Eppes CS (2017) Syphilis during pregnancy: a preventable threat to maternal-fetal health. Am J Obstet Gynecol 216(4):352–363CrossRefPubMed
20.
go back to reference Qureshi F, Jacques SM, Reyes MP (1993) Placental histopathology in syphilis. Hum Pathol 24(7):779–784CrossRefPubMed Qureshi F, Jacques SM, Reyes MP (1993) Placental histopathology in syphilis. Hum Pathol 24(7):779–784CrossRefPubMed
21.
go back to reference Benirschke K (1974) Syphilis—the placenta and the fetus. Am J Dis Child 128(2):142–143PubMed Benirschke K (1974) Syphilis—the placenta and the fetus. Am J Dis Child 128(2):142–143PubMed
22.
go back to reference Heyborne KD, Witkin SS, McGregor JA (1992) Tumor necrosis factor-alpha in midtrimester amniotic fluid is associated with impaired intrauterine fetal growth. Am J Obstet Gynecol 167(4 Pt 1):920–925CrossRefPubMed Heyborne KD, Witkin SS, McGregor JA (1992) Tumor necrosis factor-alpha in midtrimester amniotic fluid is associated with impaired intrauterine fetal growth. Am J Obstet Gynecol 167(4 Pt 1):920–925CrossRefPubMed
23.
go back to reference Helmo FR, Alves EAR, Moreira RAA et al (2018) Intrauterine infection, immune system and premature birth. J Matern Fetal Neonatal Med 31(9):1227–1233CrossRefPubMed Helmo FR, Alves EAR, Moreira RAA et al (2018) Intrauterine infection, immune system and premature birth. J Matern Fetal Neonatal Med 31(9):1227–1233CrossRefPubMed
24.
go back to reference Ortiz-Espejo M, Perez-Navero JL, Olza-Meneses J, Munoz-Villanueva MC, Aguilera-Garcia CM, Gil-Campos M (2014) Prepubertal children with a history of extra-uterine growth restriction exhibit low-grade inflammation. Br J Nutr 112(3):338–346CrossRefPubMed Ortiz-Espejo M, Perez-Navero JL, Olza-Meneses J, Munoz-Villanueva MC, Aguilera-Garcia CM, Gil-Campos M (2014) Prepubertal children with a history of extra-uterine growth restriction exhibit low-grade inflammation. Br J Nutr 112(3):338–346CrossRefPubMed
25.
go back to reference Wilke C, Renz H, Tekesin I, Hellmeyer L, Herz U, Schmidt S (2006) Suppression of IL-2 and IFN-gamma production in women with spontaneous preterm labor. J Perinat Med 34(1):20–27PubMed Wilke C, Renz H, Tekesin I, Hellmeyer L, Herz U, Schmidt S (2006) Suppression of IL-2 and IFN-gamma production in women with spontaneous preterm labor. J Perinat Med 34(1):20–27PubMed
26.
go back to reference Boyle AK, Rinaldi SF, Norman JE, Stock SJ (2017) Preterm birth: inflammation, fetal injury and treatment strategies. J Reprod Immunol 119:62–66CrossRefPubMed Boyle AK, Rinaldi SF, Norman JE, Stock SJ (2017) Preterm birth: inflammation, fetal injury and treatment strategies. J Reprod Immunol 119:62–66CrossRefPubMed
27.
go back to reference Couceiro J, Matos I, Mendes JJ, Baptista PV, Fernandes AR, Quintas A (2021) Inflammatory factors, genetic variants, and predisposition for preterm birth. Clin Genet 100(4):357–367CrossRefPubMed Couceiro J, Matos I, Mendes JJ, Baptista PV, Fernandes AR, Quintas A (2021) Inflammatory factors, genetic variants, and predisposition for preterm birth. Clin Genet 100(4):357–367CrossRefPubMed
28.
go back to reference Menon R, Dunlop AL, Kramer MR, Fortunato SJ, Hogue CJ (2011) An overview of racial disparities in preterm birth rates: caused by infection or inflammatory response? Acta Obstet Gynecol Scand 90(12):1325–1331CrossRefPubMed Menon R, Dunlop AL, Kramer MR, Fortunato SJ, Hogue CJ (2011) An overview of racial disparities in preterm birth rates: caused by infection or inflammatory response? Acta Obstet Gynecol Scand 90(12):1325–1331CrossRefPubMed
29.
go back to reference Thomas W, Speer CP (2012) Intrauterine inflammation and its sequelae: does chorioamnionitis really matter for outcome of very low birth weight infants? Z Geburtshilfe Neonatol 216(4):173–176PubMed Thomas W, Speer CP (2012) Intrauterine inflammation and its sequelae: does chorioamnionitis really matter for outcome of very low birth weight infants? Z Geburtshilfe Neonatol 216(4):173–176PubMed
30.
Metadata
Title
Associations between maternal syphilis infection during pregnancy and low birth weight and preterm birth: a prospective cohort study
Authors
Mengting Sun
Manjun Luo
Tingting Wang
Taowei Zhong
Qian Chen
Hanjun Liu
Jiapeng Tang
Liuxuan Li
Jiabi Qin
Publication date
29-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 1/2024
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-023-07321-0

Women’s health knowledge hub

Elevate your patient care with our comprehensive, evidence-based medical education on women's health. Designed to help you provide exceptional care for your female patients at every stage of life, we provide expert insights into topics such as reproductive health, menopause, breast cancer and sex-specific health risks and precision medicine.

Read more

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.   

Prof. Martha Hickey
Dr. Claudia Barth
Dr. Samar El Khoudary
Developed by: Springer Medicine
Watch now
Video