Study on the timing of blocking maternal-fetal transmission of syphilis during pregnancy

Objective To investigate the occurrence of adverse pregnant outcomes and congenital syphilis among pregnant women with syphilis who were treated in different peiriods or not treated. Methods 252 pregnant women with syphilis were divided into four groups based on the time of tretment: pre-pregnancy treatment group (102 cases), early pregnancy treatment group≤ 20 weeks of gestation, 32 cases), late pregnancy treatment group 20 weeks of gestation, 45 cases), and non-tretment group (73 cases). The incidenc of adverse pregnant outcome and congenital syphilis was compared among different groups. Results The incidence of adverse pregnant outcomes was 17.6 % for pre-pregnancy group, 32.5 % for pregnancy treatment group (the combination of early and late pregnancy treatment groups, because of no statistic difference between these two groups), and 56.2 % for non-tretment group, and the difference was significant between the three groups. The incidence of congenital syphilis (the TRUsT positive rate in neonatal cord blood or neonatal congenital syphilis with clinic diagnosis) was significantly lower in the combined group of pre-pregnancy treatment group and early pregnancy treatment group than in the late pregnancy group, and incidence in the late pregnancy group was markedly lower than in the non-treatment group. Conclusion The treatment of pregnant syphilis in pre-pregnancy or early pregnancy period can effectively decrease the occurrence of adverse pregnant outcomes and congenital syphilis. Early detection and early treatment are key measures for blocking maternal-fetal transmission of syphilis during pregnancy. The pregnant women with syphilis can be advised to terminate gestation.