Incidence and associated predictors of adverse pregnancy outcomes of maternal syphilis in China, 2016–19: a Cox regression analysis

Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China.Methods. Data were from China’s Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis.Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64) and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80) and 3.70 (95% CI 2.36 to 5.80), respectively.Conclusion. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis.

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Early-life exposure to air pollutants and adverse pregnancy outcomes: protocol for a prospective cohort study in Beijing

BMJ Open ◽

10.1136/bmjopen-2017-015895 ◽

2017 ◽

Vol 7 (9) ◽

pp. e015895 ◽

Cited By ~ 5

Author(s):

Jing Song ◽

Yi Chen ◽

Ling Wei ◽

Ying Ma ◽

Ning Tian ◽

...

Keyword(s):

Air Pollution ◽

Umbilical Cord ◽

Pregnancy Outcomes ◽

Early Life ◽

Air Pollutants ◽

Cox Regression ◽

Adverse Pregnancy Outcomes ◽

Link Type ◽

Early Life Exposure ◽

Adverse Pregnancy

IntroductionThe association between early exposure to ambient air pollution and adverse pregnancy outcomes in China is unclear. This study will assess the risk of early-life exposure to air pollutants in Beijing and explore the viability of 8-hydroxydeoxyguanosine (8-OHdG) as a biological indicator to assess oxidative stress induced by early-life exposure to air pollution.Methods and analysisHere,2500 women with singleton pregnancies and their infants will be recruited from the Beijing Obstetrics and Gynecology Hospital. We will collect nine types of biological samples, including maternal serum, urine, placental tissue, umbilical cord tissue and umbilical cord blood during all three trimesters. The air pollution data (particulate matter (PM)2.5, PM10 and similar factors) will be recorded at official fixed-site monitoring stations closest to where the pregnant women live. We plan to assess the effect of air pollutants on adverse pregnancy outcomes and infant respiratory and circulatory disease using Cox regression and competitive risk analysis and explore possible critical windows of exposure during pregnancy using daily pollutant concentrations averaged over various periods of pregnancy combined with individual activity and physiological parameters. Maternal and umbilical cord blood samples (1000 samples) will be randomly selected for 8-OHdG assays to assess the correlation between exposures to air pollutants and oxidative stress. We will determine whether air pollutant exposure or 8-OHdG levels are associated with adverse pregnancy outcomes. SPSS and SAS statistical software will be used for data analysis. Cox regression and competing risk analysis will be used to compute the HR and population attributable risk.Ethics and disseminationThis research protocol has already been approved by the Medical Ethics Committee of Beijing Obstetrics and Gynecology Hospital. Written informed consent will be obtained from all study participants prior to enrolment. The results will be published in peer-reviewed journals or disseminated through conference presentations.Trial registration numberThis study has been registered in WHO International Clinical Trial Register—Chinese Clinical Trial Registry under registrationnumber ChiCTR-ROC-16010181 (http://www.chictr.org.cn/showproj.aspx?proj=17328).

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O18.2 Estimating disease burden of maternal syphilis and associated adverse pregnancy outcomes in china

10.1136/sextrans-2019-sti.206 ◽

2019 ◽

Author(s):

Yajie Wang ◽

Xiaoli Yue ◽

Jing Li ◽

Xiangdong Gong

Keyword(s):

Pregnancy Outcomes ◽

Disease Burden ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy ◽

Maternal Syphilis

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Lupus Low Disease Activity State achievement is important for reducing adverse outcomes in pregnant patients with systemic lupus erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.200802 ◽

2020 ◽

pp. jrheum.200802

Author(s):

Ji-Won Kim ◽

Ju-Yang Jung ◽

Hyoun-Ah Kim ◽

Jeong In Yang ◽

Dong Wook Kwak ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Regression Analysis ◽

Disease Activity ◽

Lupus Erythematosus ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Systemic Lupus ◽

Low Disease Activity ◽

Adverse Pregnancy ◽

Activity State

Objective This study aimed to examine the frequency and risk factors of complications during pregnancy in women with systemic lupus erythematosus (SLE). Methods The medical records of patients with SLE and age-matched controls at Ajou University Hospital were collected. Clinical features and pregnancy complications in women with SLE were compared to those in controls. Multivariate logistic regression analysis was performed to determine the predictors of adverse maternal and fetal outcomes. Results We analyzed 163 pregnancies in patients with SLE and 596 pregnancies in the general population; no significant differences regarding demographic characteristics were noted. Lupus patients experienced a higher rate of stillbirth (odds ratio [OR], 13.2), pre-eclampsia (OR, 4.3), preterm labor (OR, 2.6), intrauterine growth retardation (OR, 2.5), admission to neonatal intensive care unit (OR, 2.2) and emergency cesarean section (OR, 1.9) than control group. Multivariate regression analysis revealed that thrombocytopenia, low complement, high proteinuria, high SLE Disease Activity Index (SLEDAI), low Lupus Low Disease Activity State (LLDAS) achievement rate, and high corticosteroid dose were associated with adverse pregnancy outcomes. In the receiver operating characteristic curve analysis, the optimal cut-off value for the cumulative and mean corticosteroid doses were 3,500 mg and 6 mg, respectively. Conclusion Pregnant women with SLE have a higher risk of adverse pregnancy outcomes. Pregnancies are recommended to be delayed until achieving LLDAS and should be closely monitored with the lowest possible dose of corticosteroids.

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