E. Folgosa et al., SYPHILIS SEROPREVALENCE AMONG PREGNANT-WOMEN AND ITS ROLE AS A RISK FACTOR FOR STILLBIRTH IN MAPUTO, MOZAMBIQUE, Genitourinary medicine, 72(5), 1996, pp. 339-342
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.