Abstract:
Objectives: To assess the impact of a syphilis control programme of pregnant women on pregnancy outcome in Kenya.
Method: Women who came to deliver to Pumwani Maternity Hospital (PMH) between April
1997 and March 1998 were tested for syphilis. Reactive rapid plasma reagin (RPR) tests were
titrated and confirmed with treponema haemagglutination test (TPHA). Equal numbers of RPR
and TPHA negative women were enrolled. Antenatal syphilis screening and treatment history
were examined from the antenatal cards.
Results: Of 22 466 women giving birth, 12 414 (55%) were tested for syphilis. Out of these, 377
(3%) were RPR reactive of whom 296 were confirmed by TPHA. Syphilis seroreactive women
had a more risky sexual behaviour and coexistent HIV antibody positivity; 26% were HIV seropositive compared with 11% among syphilis negative mothers. The incidence of adverse obstetric outcome defined as low birth weight and stillbirth, was 9.5%. Syphilis seropositive women had
a higher risk for adverse obstetric outcome (OR 4.1, 95% CI 2.4–7.2). Antenatal treatment of
RPR reactive women significantly improved pregnancy outcome but the risk of adverse outcome
remained 2.5-fold higher than the risk observed in uninfected mothers.
Conclusions: These data confirm the adverse eVect of syphilis on pregnancy outcome. This
study also shows the eYcacy of antenatal testing and prompt treatment of RPR reactive mothers
on pregnancy outcome.
(Sex Transm Inf 2000;76:117–121)
