SLR IV 6 Aim: To perform a systematic review and Pooled estimates showed that among Review includes (Gomez et al of reported estimates of adverse untreated pregnant women with syphilis, observational 2013) studies pregnancy outcomes among untreated women with fetal loss and stillbirth were 21% more studies and is of syphilis and women without syphilis. frequent, neonatal deaths were 9.3% more low to moderate frequent and prematurity or low birth methodological Settings: Malawi, Tanzania, United Kingdom, weight were 5.8% more frequent than quality (see United States, Zambia among women without syphilis. Of the Section 3.1.6) Methods: PubMed, EMBASE and Cochrane Libraries infants of mothers with untreated syphilis, were searched for literature assessing adverse 15% had clinical evidence of congenital pregnancy outcomes among untreated women with syphilis. The single study that estimated seroreactivity for Treponema pallidum infection infant death showed a 10% higher frequency and non-seroreactive women. Adverse pregnancy among infants of mothers with syphilis. outcomes were fetal loss or stillbirth, neonatal Substantial heterogeneity was found across death, prematurity or low birth weight, clinical studies in the estimates of all adverse evidence of syphilis and infant death. outcomes for both women with syphilis effects meta-analyses were used to calculate (66.5%; 95%CI 58.0 to 74.1; I2 = 91.8%; pooled estimates of adverse pregnancy outcomes P<0.001) and women without syphilis and, where appropriate, heterogeneity was (14.3%; 95%CI 11.8 to 17.2]; I2 = 95.9%; explored in group-specific analyses. P<0.001).
(Gomez et al 2013) SLR IV 6 studies Aim: To perform a systematic review and of reported estimates of adverse pregnancy outcomes among untreated women with syphilis and women without syphilis. Settings: Malawi, Tanzania, United Kingdom, United States, Zambia Methods: 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. meta-analyses were used to calculate pooled estimates of adverse pregnancy outcomes and, where appropriate, heterogeneity was explored in group-specific analyses. 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%CI 58.0 to 74.1; I2 = 91.8%; P<0.001) and women without syphilis (14.3%; 95%CI 11.8 to 17.2]; I2 = 95.9%; P<0.001). Review includes observational studies and is of low to moderate methodological quality (see Section 3.1.6) effects
Syphilis%20evidence%20evaluation%2015Oct18.DOCX