RESUMO
OBJECTIVE: To investigate the clinical characteristics of pregnant women with syphilis, their pregnant outcomes, perinatal and neonatal prognosis and the incidence of congenital syphilis. METHODS: One hundred and ninety-two pregnant women with syphilis by serological assays were divided into two groups, group A (n = 93): treated with a full course anti-syphilis therapy and group B (n = 99): untreated group. Meanwhile, they were divided into groups C and D according to maternal serum rapid plasma reagin (RPR) test: RPR titer < or = 1:8 (group C) and RPR titer > or = 1:16 (group D). The pregnant outcomes and congenital syphilis were compared between two groups. RESULTS: (1) Perinatal outcomes: Term delivery reached 93.6% (87/93) in group A and only 28.3% (28/99) in group B; the rate of premature birth and fetal intrauterine death were 5.4% (5/93) and 1.1% (1/93) in group A, obviously lower than 28.3% (28/99) and 32.3% (32/99) in group B (P < 0.005). No fetal intrauterine death and abortion occurred in the group A. Prognosis of neonates: Normal neonates were 63.0% (58/92) in group A, and only 23.2% (13/56) in group B; the rates of asphyxia neonates, low birth weight, congenital syphilis and neonatal death in group A were significantly lower than those in group B (P < 0.01). (2) The comparison between groups C and D: Term delivery rate in group C (78.1%, 89/114) was higher than that in group D (36.1%, 26/72); the rates of premature birth, congenital syphilis, perinatal death and neonatal death in group C were lower than those in group D (P < 0.01). (3) Gestational week and drug treatment: The earlier the treatment started during pregnancy, the lower the rate of congenital syphilis was (P < 0.01). The incidences of congenital syphilis were similar between penicillin and dibenzyl penicillin groups (P < 0.05). CONCLUSIONS: (1) Effective full-course anti-syphilis therapy is the key to improving the outcomes of pregnancy with syphilis, prognosis of neonates and reducing incidence of congenital syphilis. (2) Maternal serum RPR titer, the starting time of anti-syphilis treatment as well as the choice of therapeutical drugs are important influence factors on the outcomes of pregnancy with syphilis.
