Improving antenatal care to prevent adverse pregnancy outcomes caused by syphilis.

Evaluation of: Hawkes S, Matin N, Broutet N, Low N. Effectiveness of interventions to improve screening for syphilis in pregnancy: a systematic review and meta-analysis. Lancet Infect. Dis. 11(9), 684-691 (2011). Untreated maternal syphilis continues to be an important risk factor for adverse pregnancy outcomes in many developing countries, resulting in spontaneous abortion, stillbirth, premature delivery or perinatal death. In this systematic review and meta-analysis, Hawkes et al. review the effectiveness of interventions to increase the uptake of syphilis screening and treatment in pregnancy. The ten studies they review, published between 1986 and 2008, have a total sample size of more than 41,000. Overall, they showed that interventions to improve the uptake of antenatal screening for syphilis in pregnancy could reduce the syphilis-attributable incidence of stillbirth and perinatal death by 50%. As prevention of congenital syphilis costs less than US$1.50 per woman screened, the investment to scale up antenatal screening programs would be cost effective, would significantly improve pregnancy outcomes and reduce neonatal mortality.