Fetal and neonatal outcomes in syphilis infected pregnant women in Reunion Island: An observational retrospective multicentric study

To evaluate the fetal and neonatal morbidity and mortality in pregnant women with syphilis during their pregnancy in Reunion Island, population benefiting from early and well-conducted screening and treatment. This is a retrospective observational study conducted in the four Reunion hospital centers between 2017 and 2022. The included patients were all pregnant patients with a biologically proven syphilitic infection and having given birth in one of the four centers mentioned. 108 patients were included, with 113 fetuses and newborns. Fetal mortality rate was 2.7%, neonatal mortality rate was 1.8% and congenital syphilis rate was 7%. Despite 37% of patients with a vulnerable psycho-social context, 72% were screened early, 13% in the second trimester, 44% had received optimal treatment and 48% optimal syphilis monitoring. We found 43% of obstetric complications with 12% of IUGR and 4.6% of pre-eclampsia. 21% of newborns were preterm and 17% small for gestational age. There was a significant trend between psycho-social vulnerability and congenital syphilis. Fetal and neonatal morbidity and mortality is low in our Reunion Island population where screening and treatment of syphilis are early and well conducted, although a vulnerable group of patients remain who require specific antenatal care.