Evidence table: Outcomes associated with syphilis during pregnancy Study ref Design LoE N Aim, setting, methods Results Comments SLR IV 8 studies Aim: To perform a systematic review and Women with GS had increased odds of Review includes (Arnesen et al of reported estimates of the association stillbirth (pooled OR 6.87; 95%CI 2.93 to observational 2015) between gestational syphilis (GS) and stillbirth. 16.08). There was considerable studies and is of heterogeneity across the studies (I2= 95). low to moderate Setting: the Americas The funnel plot was not statistically methodological Methods: Cochrane Library, Embase, LILACS, significant, pointing to a lack of publication quality (see MEDLINE/PubMed, PLOS, and ScienceDirect were bias. Increased odds of stillbirth among Section 3.1.6) searched for original research studies quantifying pregnant women with syphilis were also the relationship between GS and stillbirth in the seen in all four subgroup meta-analyses. region. A cumulative meta-analysis plus four subgroup meta-analyses of study data on the association between maternal syphilis during pregnancy and stillbirth were conducted. The four meta-analyses were based on 1) definition of cases and the control; 2) syphilis treatment (presence or absence, effective or ineffective); 3) definition of stillbirth as “showing no signs of life at birth”; and 4) definition of stillbirth based on low birth weight and gestational age. Random-effects meta-analyses were used to calculate pooled estimates of stillbirth with exposure to GS, and each subgroup analysis was tested for heterogeneity.
Evidence table: Outcomes associated with syphilis during pregnancy Study ref Design LoE N Aim, setting, methods Results Comments (Arnesen et al 2015) SLR IV 8 studies Aim: To perform a systematic review and of reported estimates of the association between gestational syphilis (GS) and stillbirth. Setting: the Americas Methods: Cochrane Library, Embase, LILACS, MEDLINE/PubMed, PLOS, and ScienceDirect were searched for original research studies quantifying the relationship between GS and stillbirth in the region. A cumulative meta-analysis plus four subgroup meta-analyses of study data on the association between maternal syphilis during pregnancy and stillbirth were conducted. The four meta-analyses were based on 1) definition of cases and the control; 2) syphilis treatment (presence or absence, effective or ineffective); 3) definition of stillbirth as “showing no signs of life at birth”; and 4) definition of stillbirth based on low birth weight and gestational age. Random-effects meta-analyses were used to calculate pooled estimates of stillbirth with exposure to GS, and each subgroup analysis was tested for heterogeneity. Women with GS had increased odds of stillbirth (pooled OR 6.87; 95%CI 2.93 to 16.08). There was considerable heterogeneity across the studies (I2= 95). The funnel plot was not statistically significant, pointing to a lack of publication bias. Increased odds of stillbirth among pregnant women with syphilis were also seen in all four subgroup meta-analyses. Review includes observational studies and is of low to moderate methodological quality (see Section 3.1.6)
Syphilis%20evidence%20evaluation%2015Oct18.DOCX