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February 28, 2013

Many Syphilis-Infected Pregnant Women Not Being Diagnosed, Treated

by Jessica Berman

More than one million pregnant women worldwide are infected with syphilis.  Worse still is that many of them don’t know they're infected,  which puts them and their unborn child at serious risk. The problem, a new World Health Organization study finds, is that in many regions of the world, testing and treatment services for the venereal disease are not as widely available as they should be.  

Syphilis is a sexually-transmitted disease that, according to WHO estimates, infected 1.4 million women globally in 2008.  Using data from 97 countries and 147 pre-natal clinics, investigators found that only 30 percent of women in Africa and the Mediterranean were adequately tested and treated for the disease. The percentage of women diagnosed and treated for syphilis in Europe was 70 percent.

Researchers say syphilis infections caused some 520,000 bad pregnancy outcomes, including 215,000 stillbirths, 90,000 infant deaths and 65,000 pre-term or low-weight babies. The disease was also responsible for 150,000 birth defects, according to researchers, who used a mathematical model to arrive at their conclusions.

Lead researcher Lori Newman says the bacterium which causes syphilis crosses the placenta, affecting the fetus at a critical time of development.

“At about 16 or 17 weeks of pregnancy, when the baby’s immune system starts to kick in and become active, the baby’s and the mother’s response to the infection is to cause a stillbirth or to cause severe organ damage," said Newman.

Newman, an analyst with the World Health Organization in Geneva, led the study. Newman said she is most troubled by the fact that an estimated two-thirds of the women who endured bad pregnancy outcomes had visited pre-natal clinics but were not tested for syphilis, which is easy to treat with antibiotics.

“People know historically that syphilis was a serious disease," she said. "But people thought once penicillin was invented, that it was a disease we had conquered.  But it’s important for these data [to] be shared with the world to make people understand that syphilis is still killing babies and affecting women and men all over the world.”

Newman says researchers are in the process of updating their data to encourage early diagnosis and treatment of syphilis in expectant mothers.

The study assessing the global burden of syphilis in pregnant women is published in the journal PLOS Medicine.