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<strong>KCE</strong> reports vol. 6A Prenatale zorg 148 Study Ref Population Intervention Outcomes Results Comments Study type EL 8.5% died in neonatal period (vs. 2.2%) 2% live birth to infected infant (vs. 0%) 77% chance of birth to healthy, uninfected infant (vs. 95%) reported Fiumara et 4 1005 pregnant women Syphilis diagnosis Pregnancy outcomes 24 had syphilis, 13 of which CS 3 al., 1952 [458] admitted in labour in occurred either before were old and treated cases, Boston, USA in 1951 pregnancy, antenatally Preterm birth defined as 11 diagnosed antenatally or or after delivery gestational age less than 37 weeks after delivery None resulted in congenital syphilis Rotchford et al., 2000 4 [459] 1783 pregnant women from 12 clinics in South Africa screened for syphilis at first antenatal care visit between June and Oct 1998 Adequate (n = 108) vs. inadequate (n = 50; includes n = 30 no treatment) with penicillin Inadequate = less than 2 doses Adequate = at least 2 doses Perinatal outcome in mother (because data on how many live births were twin pregnancies not available) 6/24 preterm births (25%) compared with 113/981 (11.5%) among women without syphilis (NS) Of 1783 women, 158 tested positive for syphilis, data on pregnancy outcome available for 142 women 17 perinatal deaths among 15 women; stillbirths among 6 women; 9 women had early neonatal deaths Of 43 inadequately treated women for whom pregnancy outcome was Baseline findings from RCT Treatment: 3 weekly intramuscular injections of 2.4 megaunits of benzathine penicillin (as per DoH South Africa) Perinatal death defined as stillbirth or early neonatal death CS 3
<strong>KCE</strong> reports vol. 6A Prenatale zorg 149 Study Ref Population Intervention Outcomes Results known, 11 experienced perinatal death compared to 4 among treated women (99 for whom pregnancy outcome was known); p < 0.0001 Comments Study type Lumbiganon, 2002 82 24,526 pregnant women. Data missing in 257 women. 24,269 women remain. The population was enrolled in a multicentre RCT in clinics located in Argentina, Cuba, Saudi Arabia and Thailand. Screening at the first antenatal visit and after delivery Measurement of the effect of syphilis at initiation of pregnancy, acquired during pregnancy and syphilis during the pregnancy period on pregnancy outcomes Outcome Syphilis status Risk reduction (adjusted for age and gravidity) for each additional dose of penicillin: 1 dose: 41% (95% CI 2% to 64%) 2 doses: 65% (95% CI 42% to 79%) 3 doses: 79% (95% CI 66% to 88%) OR and 95% CI The effect of syphilis at initiation of pregnancy Preterm
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KCE reports 1. Effectiviteit en kos
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