Short-term outcome and characteristics of neonates exposed to maternal syphilis admitted at Charlotte Maxeke Johannesburg Academic Hospital

Abstract

Introduction: The maternal syphilis prevalence in South Africa is increasing. This is a significant public health concern given that exposure to syphilis is linked with adverse outcomes during and after birth. Objectives: To examine the attributes and immediate outcomes of newborns exposed to maternal syphilis in comparison with those unexposed. Methods: This research entailed a retrospective, descriptive analysis of newborns admitted to the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) who were exposed to syphilis from January 1, 2015, to December 31, 2020. Data retrieval was conducted via a neonatal computerized database, emphasizing demographic information, perinatal history, clinical features, and outcomes. Results: During the study timeframe, a total of 10,059 newborns were admitted. The average hospital stay was seven days, with a standard deviation (SD) of 15 days. The average gestational age at birth was 34 weeks, with an SD of 9 weeks. Out of the total admissions, 934 (9.3%) neonates had been exposed to syphilis. Among these, 185 (19.81%) succumbed while hospitalized. There was no available information on maternal treatment from the reviewed records. The median birth weight for exposed neonates was significantly lower (1790 grams, interquartile range [IQR]=1330-2690 grams) in comparison to unexposed neonates (2110 grams, IQR=1390-3030 grams, p<0.001). Additionally, the gestational age at birth for syphilis- exposed neonates was notably lower (33 weeks, IQR=30-38 weeks) than that of their unexposed counterparts (35 weeks, IQR=30-39 weeks, p<0.001). Slightly more than half of the neonates exposed to syphilis (487/934, 52.1%) were born to mothers who had participated in antenatal care services. iv Conclusions: Almost one-tenth of neonates were exposed to syphilis in this study and of those exposed neonates, one in five were recorded as dead. Over half of exposed neonates were born from mothers who attended antenatal care. Unless screening, testing, and treatment of maternal syphilis in pregnancy is strengthened in South African public health settings, a significant proportion of pregnancies might develop maternal syphilis which might result in adverse outcomes in exposed neonates. Our study emphasizes the importance of adequate resource allocation that will reduce maternal syphilis]and perinatal mortality.