Syphilis in pregnant women and their newborn infants in South-East Queensland 2016-2021: A retrospective audit of management and outcomes

Duration: 2016 – 2022

Funding Source: Sexual Health Research Foundation/ASHM

Chief Investigators: Clare Nourse, Judith Dean, Mandy Wu, Mandy Seel, Sumi Britton, Li jun Theah,

Aim

To evaluate the management of syphilis in pregnant women and their infants to identify gaps in care to prevent CS. Additionally, we aim to perform qualitative interviews of health care workers and women to identify gaps in knowledge that contribute to gaps in management

Background

Infectious syphilis notifications are increasing in Australia with a well-documented outbreak in remote and regional areas.

Key Clinical Challenges Include:

• In Queensland, 66% of notifications in 2019 were from South-East Queensland (SEQ), mainly among non-Indigenous people.
• There has been a concomitant rise in syphilis in pregnancy and congenital syphilis (CS) due to vertical transmission.
• Appropriate management of syphilis in pregnancy includes antenatal screening, contact tracing and management, penicillin treatment >30 days before delivery and serological follow-up to ensure adequate treatment and exclude re-infection.
• If management is ineffective, mother-to-child-transmission leads to acute and chronic sequelae e.g CS, preterm and low birth weight deliveries, miscarriage, stillbirth and ­­neonatal death.

Impact

Recommendations have been made to improve management of syphilis in pregnancy

Ongoing research to identify gaps in knowledge of HCW and patients.