MICHAELA FLEMING CROI 2020
Syphilis cases have increased among women in the United States since 2013. In fact, rates of congenital syphilis are at their highest point in 20 years. This is concerning because this infection during pregnancy can lead to stillbirth.
A team of researchers from the University of Alabama at Birmingham hypothesized that syphilis infection in women with and without HIV may be a way to identify people who are at high risk of stillbirth.
The study team reported on their research in a poster session at the Conference on Retroviruses and Opportunistic Infections (CROI 2020).
This is a multicenter study of HIV in US women between 1994 and 2016. The data included documented evidence of syphilis and pregnancy outcomes in women aged 16 to 49 years. A total of 3577 women were included, 2687 (75%) of whom were living with HIV and 879 (25%) of whom were HIV-negative.
The mean age at inclusion was 36 years and syphilis was defined as a positive RPR test with confirmatory treponemal antibody tests at the start of the study.
La prevalencia de sifilis fue mayor en mujeres con VIH en comparación a mujeres sin VIH (8% frente a 4%, P <0.05).
In the study, the history of fetal death and fetal death during follow-up were examined separately.
Birth outcomes were self-reported, with 4.6% reporting fetal deaths during the study period and 2.2% of pregnant women reporting during follow-up.
During follow-up, 4.7% of women with syphilis had fetal death compared to 2.0% of women who were seronegative for syphilis.
«Predictores de muerte fetal en el modelo no ajustado ( P<0.2) incluía sífilis al inicio del estudio, estado VIH negativo, raza negra, identidad no heterosexual, ingresos <$ 12,000, VHC, mayor edad y el inicio temprano de vida sexual», escribieron los autores del estudio en su resumen.
The reported fetal death rates were 4 times higher compared to the general population.
"Early prenatal care and syphilis screening is critical for American women living with HIV or at risk of contracting HIV," the authors concluded.
https://www.contagionlive.com/news/prenatal-care-universal-syphilis-screening-critical-for-us-women