The resurgence of syphilis among pregnant women in southern Chile

ABSTRACT Background: National rates of HIV, gonorrhoeae and syphilis have increased in Chile in recent years, but it is not known if syphilis among pregnant women (PW) is also escalating. Aim: To explore syphilis rates among PW in a southern Chilean region and to describe clinical features of moth...

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Autores principales:	Fica,Alberto, Montiel,Pamela, Saavedra,SofÍa, Meissner,MatÍas, VelÁsquez,Juan Carlos
Lenguaje:	English
Publicado:	Sociedad Médica de Santiago 2021
Materias:	Pregnancy Premature Birth Syphilis Syphilis, Congenital Syphilis Serodiagnosis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872021000300348
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spelling	oai:scielo:S0034-988720210003003482021-10-14The resurgence of syphilis among pregnant women in southern ChileFica,AlbertoMontiel,PamelaSaavedra,SofÍaMeissner,MatÍasVelÁsquez,Juan Carlos Pregnancy Premature Birth Syphilis Syphilis, Congenital Syphilis Serodiagnosis ABSTRACT Background: National rates of HIV, gonorrhoeae and syphilis have increased in Chile in recent years, but it is not known if syphilis among pregnant women (PW) is also escalating. Aim: To explore syphilis rates among PW in a southern Chilean region and to describe clinical features of mothers and offspring. Patients and Methods: We selected PW with positive VDRL or T. pallidum micro-he-magglutination (MHA-TP) reactive tests, referred to a high-risk obstetrical pathology center between 2011 and 2019. Clinical information of mothers and their offspring was obtained from their medical records. Results: Syphilis rates among PW increased from 0.4 to 7.2 per 1,000 live births in the reference center from 2013 to 2019, along with a national and regional increase in both sexes. Twenty-nine cases of PW with syphilis were identified with a median age of 28 years (interquartile range 23-32). Seventeen percent had a history of drug abuse, and 14% had previous sexually transmitted diseases. In seven cases (24%), the diagnosis occurred at delivery. Three percent of patients had a primary syphilis, 14% a secondary syphilis, 24% an early latent syphilis, and 59% a latent syphilis. All cases except one case were treated with benzathine penicillin G and the remaining with erythromycin due to allergy suspicion. Penicillin desensitization was required in two cases (7%). Treatment timing was inadequate in 10 cases (34.5%). Of 19 patients with available serological follow-up, 10 (53%) showed a significant decrease in VDRL titers (≥ 2 dilutions) and two cases had re-infection. Two patients (7%) had an abortion, two had congenital syphilis (7%), and six had premature births (21%), totaling 35% of adverse-pregnancy outcomes. Conclusions: Resurgence of syphilis among pregnant women is happening in southern Chile and is associated to adverse-pregnancy outcomes.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.149 n.3 20212021-03-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872021000300348en10.4067/s0034-98872021000300348
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Pregnancy Premature Birth Syphilis Syphilis, Congenital Syphilis Serodiagnosis
spellingShingle	Pregnancy Premature Birth Syphilis Syphilis, Congenital Syphilis Serodiagnosis Fica,Alberto Montiel,Pamela Saavedra,SofÍa Meissner,MatÍas VelÁsquez,Juan Carlos The resurgence of syphilis among pregnant women in southern Chile
description	ABSTRACT Background: National rates of HIV, gonorrhoeae and syphilis have increased in Chile in recent years, but it is not known if syphilis among pregnant women (PW) is also escalating. Aim: To explore syphilis rates among PW in a southern Chilean region and to describe clinical features of mothers and offspring. Patients and Methods: We selected PW with positive VDRL or T. pallidum micro-he-magglutination (MHA-TP) reactive tests, referred to a high-risk obstetrical pathology center between 2011 and 2019. Clinical information of mothers and their offspring was obtained from their medical records. Results: Syphilis rates among PW increased from 0.4 to 7.2 per 1,000 live births in the reference center from 2013 to 2019, along with a national and regional increase in both sexes. Twenty-nine cases of PW with syphilis were identified with a median age of 28 years (interquartile range 23-32). Seventeen percent had a history of drug abuse, and 14% had previous sexually transmitted diseases. In seven cases (24%), the diagnosis occurred at delivery. Three percent of patients had a primary syphilis, 14% a secondary syphilis, 24% an early latent syphilis, and 59% a latent syphilis. All cases except one case were treated with benzathine penicillin G and the remaining with erythromycin due to allergy suspicion. Penicillin desensitization was required in two cases (7%). Treatment timing was inadequate in 10 cases (34.5%). Of 19 patients with available serological follow-up, 10 (53%) showed a significant decrease in VDRL titers (≥ 2 dilutions) and two cases had re-infection. Two patients (7%) had an abortion, two had congenital syphilis (7%), and six had premature births (21%), totaling 35% of adverse-pregnancy outcomes. Conclusions: Resurgence of syphilis among pregnant women is happening in southern Chile and is associated to adverse-pregnancy outcomes.
author	Fica,Alberto Montiel,Pamela Saavedra,SofÍa Meissner,MatÍas VelÁsquez,Juan Carlos
author_facet	Fica,Alberto Montiel,Pamela Saavedra,SofÍa Meissner,MatÍas VelÁsquez,Juan Carlos
author_sort	Fica,Alberto
title	The resurgence of syphilis among pregnant women in southern Chile
title_short	The resurgence of syphilis among pregnant women in southern Chile
title_full	The resurgence of syphilis among pregnant women in southern Chile
title_fullStr	The resurgence of syphilis among pregnant women in southern Chile
title_full_unstemmed	The resurgence of syphilis among pregnant women in southern Chile
title_sort	resurgence of syphilis among pregnant women in southern chile
publisher	Sociedad Médica de Santiago
publishDate	2021
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872021000300348
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The resurgence of syphilis among pregnant women in southern Chile

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