Sodiq Ojuroungbe
Gynaecologists have said untreated syphilis in pregnancy could lead to severe health complications for unborn babies, including stillbirth, congenital abnormalities, and long-term developmental issues.
The maternal health experts noted that syphilis, an infection caused by the bacterium Treponema pallidum, could lead to poor pregnancy outcomes, stressing the urgent need for effective screening and treatment during pregnancy.
Speaking with PUNCH Healthwise, the experts noted that by increasing awareness and ensuring that all pregnant women have access to screening and treatment, it was possible to reduce the incidence of congenital syphilis and improve outcomes for both mothers and their babies.
The World Health Organisation states that syphilis is one of the most common sexually transmitted infections globally, with approximately 6 million new cases each year.
The global health body noted that if a pregnant woman who is infected does not receive early and effective treatment, she can then transmit the infection to her unborn infant (this is known as congenital syphilis).
In 2016, WHO estimated approximately 661,000 cases of congenital syphilis globally. These cases included 143,000 early fetal deaths and stillbirths, 61,000 neonatal deaths, 41,000 preterm or low-birth-weight births, and 109,000 infants diagnosed with congenital syphilis.
According to the international health organisation, the disease remains the second leading cause of preventable stillbirths worldwide, following malaria.
WHO’s estimates reveal that 57 per cent of adverse birth outcomes occurred in pregnant women who attended antenatal care but were not screened for syphilis. Another 16 per cent of adverse outcomes were linked to women who were screened but did not receive adequate treatment.
Despite the progress, WHO reports that syphilis testing and treatment coverage among pregnant women remains insufficient in many regions.
Reacting, the maternal health experts told our correspondent that untreated syphilis in pregnant women may lead to premature delivery, low birth weight, and restricted fetal growth.
A gynaecology oncologist at Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Professor Kayode Ajenifuja, noted that syphilis could result in a range of severe conditions, including low red blood cell counts, liver dysfunction, and neurological issues.
The fellow of the West African College of Surgeons, explained that infants born to mothers with untreated syphilis may suffer from bone deformities, enlarged organs, and developmental delays.
Ajenifuja added that the transmission of syphilis from mother to baby can occur either through the placenta during pregnancy or delivery through contact with infectious lesions.
The don stated that the effects of congenital syphilis are profound, with about 50-80 per cent of cases resulting in adverse outcomes such as stillbirth or death within the first week of life.
According to him, infants born to mothers with untreated syphilis may develop a range of health issues. These include anaemia, low platelet counts, liver dysfunction, and infections of long bones and cartilage.
He stressed that affected babies are at high risk of developing neurosyphilis, which can lead to meningitis, convulsions, and defects in the eyes and other cranial nerves.
The professor said late manifestations of congenital syphilis may include bone deformities, enlarged organs, and developmental delays.
These issues, he insisted, can affect the child’s ability to achieve normal developmental milestones and may result in chronic health problems throughout their life.
He said, “Syphilis is an infectious disease caused by a bacterium called Treponema Pallidum. It is sexually transmitted by contact with infectious lesions and mucus membranes and vertically through the placenta from the mother to the foetus or during the passage of the baby through the birth canal at birth.
“Adverse effects are common in about 50-80 per cent of cases. Stillbirth or death of the newborn within 7 days of birth in advanced syphilis. In mild to moderate cases premature birth, low birth weight babies, or congenital syphilis
“Both low red blood cells, low platelets, dysfunction of the liver and gallbladder, infections of the long bones and cartilages and syphilitic rhinitis. More than half of affected babies may develop neurosyphilis leading to meningitis and convulsions, defects in the eyes and other nerves supplying the head and neck region.
“Late manifestations include deformed bones, enlarged liver and spleen. Poor development of developmental milestones
“Many cases, especially mild forms may be asymptomatic, so many cases are missed. Babies of mothers with syphilis should be tested and treated if positive.”
While noting that early detection of syphilis during pregnancy is crucial for preventing these severe outcomes, Ajenifuja stressed that routine screening at antenatal clinics is recommended by WHO.
He added that early diagnosis allows for timely treatment, which can mitigate the risks of congenital syphilis and prevent the transmission of the disease to the unborn child.
The reproductive expert also emphasised that many cases of congenital syphilis are asymptomatic, making it essential for all pregnant women to be tested.
He maintained that failure to screen and treat syphilis could result in missed diagnoses and subsequent severe health complications for the infant.
Dr. Akinde Joseph
Corroborating him, a renowned obstetrician and gynaecologist, Dr. Joseph Akinde said untreated or poorly treated syphilis could lead to chronic infections that severely impact the vital organs of newborns.
The reproductive health expert who is a former Chairman of the Society of Gynaecology and Obstetrics of Nigeria, Lagos State chapter, explained that these infections in pregnant women could result in intrauterine fetal death, stillbirth, or malformed babies.
According to Akinde, the progression of syphilis to a chronic stage can cause severe complications in both the mother and her unborn child.
The maternal health expert stated that syphilis can interfere with the normal development of the fetus, leading to premature birth and low birth weight.
He added that infants born under such conditions are at risk of restricted fetal growth, which can have long-term developmental consequences.
Such babies, he revealed, may be born with growth deficiencies or as small for gestational age, conditions that are indicative of underlying congenital syphilis.
The gynaecologist emphasised that untreated syphilis could also lead to severe complications during the neonatal period.
He said babies may present with a range of issues including bone deformities, heart defects, and other cardiovascular problems.
“Untreated or poorly treated infections in the woman become chronic syphilis which can go on to damage vital organs such as the heart or brain/spinal cord in the woman and may result in intrauterine fetal death or stillbirth or malformed baby if the woman gets pregnant
“Premature delivery abortions or miscarriages, as well as malformed babies, can result from syphilis infections which were not treated or adequately treated. Such infections can result in restricted fetal growth and this may have long-term consequences on fetal development even if such babies were to be born alive
“Poor fetal growth with babies being born with low birth weight or being born as small for gestational age Poor growth in the neonatal period congenital malformations of the heart or cardiovascular systems are some pointers to congenital syphilis requiring tests to be carried out in the mother and or baby to confirm the diagnosis,” he explained.
On prevention, Akinde advocated for routine screening for syphilis during prenatal care.
He said early detection allows for timely treatment, which is crucial in preventing the severe outcomes associated with the disease.
He maintained, “Early detection in the pregnancy would ensure adequate treatment to prevent all the unfavourable outcomes as well as prevent transmission of the disease from the mother to the baby developing in the womb.”
When asked about people at higher risk of syphilis, the reproductive expert added, “Poverty, drug abuse, promiscuity, and multiple sexual partners are some of the reasons why people may be at high risk of infection with syphilis
“Needful public enlightenment and health education on the need for screening in early pregnancy will go a long way to help curtail the problem.”
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