SYPHILIS SEROPREVALENCE AMONG PREGNANT-WOMEN AND ITS ROLE AS A RISK FACTOR FOR STILLBIRTH IN MAPUTO, MOZAMBIQUE

Objective: To elucidate the role of current syphilis as a risk factor for foetal death. Methods: Sera were obtained from 57 women with third trimester foetal death (cases) and 58 women with foetus alive (contro ls) matched for age and parity. All sera reactive in qualitative Rapid Plasma Reagin (RPR) analyses were tested with serial twofold dilution s to determine endpoint flocculation titres and tested with the micro- haemagglutination assay for Treponema pallidum (MHA-TP). Placental bio psies were sectioned and stained by haematoxylin-eosin and Warthin-Sta rry for light microscopy. Setting: Central Hospital, in Maputo, Mozamb ique, from January 1990 to June 1991. Results: The MHA-TP was reactive in 42% of cases and in 12% of controls (OR = 5.3; 95% CI: 1.9-15.4). The RPR card test was reactive at the dilution of 1:32 or greater in 2 8% of cases and in 7% of controls. All these results were confirmed by MHA-TP (OR = 5.3; 95% CI: 1.5-15.4). In 9/28 (32%) MHA-TP seroreactiv e women (7 cases and 2 controls) placental morphological changes indic ated syphilitic infection. Conclusion: MHA-TP seroreactivity and high titre RPR were associated with stillbirth. Morphological changes presu mptive of syphilis infection were found in 32% placentas histologicall y studied. Syphilis is a risk factor for foetal death in Maputo, Mozam bique.