Obstetric Outcomes Associated with Maternal Syphilis Infection in U.S. Deliveries [4J]

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Syphilis infections affect millions of pregnant women worldwide every year. The recent epidemic in the United States necessitates further investigation into the adverse effects of syphilis infection during pregnancy. Our goal was to examine the association of maternal syphilis infection with adverse pregnancy outcomes.


This was a retrospective cohort study that included 10,483,736 women with singleton gestations delivering in the United States from 2011 through 2013. Simple proportions of obstetric complications were compared between pregnant women infected with syphilis and controls. Chi square tests and multivariable regression were used for statistical analysis, with p<0.05 as the cut-off for significance. Comparisons were controlled for co-infection, parity, congenital abnormality, and maternal race and ethnicity, age, education attainment, cigarette use, and weight.


A total of 7,148 pregnancies in this analysis were complicated by maternal infection with syphilis. Infection was positively associated with gestational diabetes (adj. OR: 1.33), gestational hypertension (1.36), caesarean section (1.15), maternal ICU stay (2.17), preterm delivery (1.13), NICU stay (1.74), neonate ventilator use for longer than 6 hours (1.37), and congenital abnormality (1.49).


Syphilis infection in pregnancy is associated with increased odds of several adverse obstetric outcomes and increased health care system costs. Although it has been demonstrated that screening pregnant women for syphilis to reduce adverse outcomes is cost-effective, further research is necessary to investigate the detailed mechanisms of morbidity.

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