Treatment efficacy and pregnancy outcomes among pregnant women with syphilis in a low-prevalence setting

Introduction: Vertical transmission of syphilis is a global health concern, and understanding pregnancy outcomes following treatment is essential for addressing this issue on a global or local scale.
Objective: To determine the incidence of early syphilis in pregnancy and to evaluate the effectiveness of treatment in preventing vertical transmission of syphilis.
Method: The study used secondary data. The database was developed based on the case investigation form completed for each pregnant woman diagnosed with syphilis during the period 2017-2020.
Results: There were 181 pregnant women diagnosed with syphilis. Adverse birth outcomes (ABOs) in previous pregnancies were significantly high (37.82%) in the sample (n=119). Among pregnant women with syphilis, 35.36% had early syphilis (primary, secondary and early latent) with an average incidence rate of early syphilis of 5 per 100,000 pregnant women tested per year. All pregnant women with early syphilis were treated with benzathine penicillin, and almost all partners were traced and managed. There was no significant difference in the ABOs between the early syphilis group (9.37%) and the late syphilis group (11.20%) (p>0.05). In the early syphilis group, two babies (3.1%) had confirmed congenital syphilis (CS) with none in the late syphilis group.
Conclusion: Adverse pregnancy outcomes during previous pregnancies were high among women diagnosed with syphilis. The study findings confirm the low incidence of early syphilis among pregnant women in Sri Lanka. It further proves that the provision of quality services minimises ABOs due to vertical transmission of syphilis.