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Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis

Bulletin of the World Health Organization, 2013-03, Vol.91 (3), p.217-226 [Peer Reviewed Journal]

2014 INIST-CNRS ;Copyright World Health Organization Mar 2013 ;(c) World Health Organization (WHO) 2013. All rights reserved. 2013 ;This work is licensed under a Creative Commons Attribution 3.0 International License. ;ISSN: 0042-9686 ;EISSN: 1564-0604 ;DOI: 10.2471/blt.12.107623 ;PMID: 23476094 ;CODEN: BWHOA6

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Title:
Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis
Author: GOMEZ, Gabriela B ; KAMB, Mary L ; NEWMAN, Lori M ; MARK, Jennifer ; BROUTET, Nathalie ; HAWKES, Sarah J
Subjects: Anti-Bacterial Agents - therapeutic use ; Bacterial diseases ; Bacterial diseases of the genital system ; Biological and medical sciences ; Birth ; Death ; Estimates ; Female ; Fetal Death - epidemiology ; Fetal Death - etiology ; General aspects ; Health ; Health Policy & Services ; Human bacterial diseases ; Humans ; Infant Mortality ; Infant, Low Birth Weight ; Infant, Newborn ; Infants ; Infectious diseases ; Libraries ; Medical sciences ; Miscellaneous ; Mortality ; Penicillins - therapeutic use ; Pregnancy ; Pregnancy Complications, Infectious - diagnosis ; Pregnancy Complications, Infectious - drug therapy ; Pregnancy Outcome - epidemiology ; Premature Birth ; Prenatal Care - methods ; Prenatal Care - standards ; Prenatal Care - statistics & numerical data ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Stillbirth - epidemiology ; Studies ; Syphilis ; Syphilis - complications ; Syphilis - diagnosis ; Syphilis - drug therapy ; Syphilis, Congenital - epidemiology ; Syphilis, Congenital - prevention & control ; Systematic Reviews ; Womens health
Is Part Of: Bulletin of the World Health Organization, 2013-03, Vol.91 (3), p.217-226
Description: To perform a systematic review and meta-analysis of reported estimates of adverse pregnancy outcomes among untreated women with syphilis and women without syphilis. PubMed, EMBASE and Cochrane Libraries were searched for literature assessing adverse pregnancy outcomes among untreated women with seroreactivity for Treponema pallidum infection and non-seroreactive women. Adverse pregnancy outcomes were fetal loss or stillbirth, neonatal death, prematurity or low birth weight, clinical evidence of syphilis and infant death. Random-effects meta-analyses were used to calculate pooled estimates of adverse pregnancy outcomes and, where appropriate, heterogeneity was explored in group-specific analyses. Of the 3258 citations identified, only six, all case-control studies, were included in the analysis. Pooled estimates showed that among untreated pregnant women with syphilis, fetal loss and stillbirth were 21% more frequent, neonatal deaths were 9.3% more frequent and prematurity or low birth weight were 5.8% more frequent than among women without syphilis. Of the infants of mothers with untreated syphilis, 15% had clinical evidence of congenital syphilis. The single study that estimated infant death showed a 10% higher frequency among infants of mothers with syphilis. Substantial heterogeneity was found across studies in the estimates of all adverse outcomes for both women with syphilis (66.5% [95% confidence interval, CI: 58.0-74.1]; I(2) = 91.8%; P < 0.001) and women without syphilis (14.3% [95% CI: 11.8-17.2]; I(2) = 95.9%; P < 0.001). Untreated maternal syphilis is associated with adverse pregnancy outcomes. These findings can inform policy decisions on resource allocation for the detection of syphilis and its timely treatment in pregnant women.
Publisher: Genève: Organisation mondiale de la santé
Language: English;Portuguese
Identifier: ISSN: 0042-9686
EISSN: 1564-0604
DOI: 10.2471/blt.12.107623
PMID: 23476094
CODEN: BWHOA6
Source: SciELO
Geneva Foundation Free Medical Journals at publisher websites
AUTh Library subscriptions: ProQuest Central
MEDLINE
PubMed Central
DOAJ Directory of Open Access Journals

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Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis

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