Seroprevalence and risk factors of syphilis infection in pregnant women delivering at Harare Maternity Hospital, Zimbabwe.

OBJECTIVE: To evaluate risk factors and outcomes of syphilis during pregnancy. DESIGN: Hospital based, cross sectional study. SETTING: Harare Maternity Hospital, Harare, Zimbabwe. SUBJECTS: A random sample of 2 969 pregnant women. MAIN OUTCOME MEASURES: Syphilis seroprevalence. RESULTS: Of the 2 969 women who provided blood samples, 4.8% were RPR positive. Approximately 2.2% of study subjects were RPR positive and TPHA negative. Notably, 2.5% of the population was RPR and TPHA positive at the time of giving birth. Older women had a higher risk of having positive syphilis status (p = 0.057). Increases in parity and gravidity were significantly associated with increased risk of syphilis infection. Prior stillbirths were associated with an increased risk of syphilis infection (odds ratio [OR], 3.4; 95% CI, 1.61 to 7.37; p = 0.001). Syphilis positive mothers were significantly more likely to give birth to syphilis positive newborns (p < 0.0001). CONCLUSIONS: Our results suggest that there should be more effective antenatal screening and treatment of syphilis in Harare. Syphilis affects many sub-Saharan countries where effective educational outreach, screening, and treatment should take place to prevent the transmission of this venereal disease, especially among reproductive age and pregnant women.