Risk factors for syphilis infection among pregnant women: results of a case-control study in Shenzhen, China

Background: China has been experiencing a rapidly growing syphilis epidemic since the early 1990s, with the reported incidence of congenital syphilis increasing from 0.01 cases per 100 000 live births in 1991 to 19.7 cases per 100 000 live births in 2005. Detailed studies of risk factors for syphilis in pregnant women are needed to inform new preventive interventions. Objective: To investigate factors associated with recent syphilis infection among pregnant women and recommend strategies for improved preventive interventions in the community. Methods: A case–control study was conducted among women attending antenatal clinics in Shenzhen City, South China. Cases were antenatal clinic women testing positive for early syphilis, based on laboratory results, with those testing negative being controls. All participants completed the same anonymous questionnaire covering demographics, lifestyle, sexual behaviour, and sexual partnerships. Results: 129 cases and 345 controls were recruited. Syphilis was significantly associated with unmarried status, less education, multiple sex partners, travel of sex partner in the past 12 months, a history of induced abortion, and previous sexually transmitted infections. Overall, there were no differences between syphilis-positive and negative women in household registration status (hukou), living district and duration in Shenzhen, monthly income, and age at first sex. Conclusions: Many demographic and behavioural risk factors are associated with syphilis among pregnant women. In the government congenital syphilis control programme, comprehensive preventive interventions should be provided in all clinical settings in addition to the current procedures for syphilis screening among antenatal women.

[1]  Jinquan Cheng,et al.  Syphilis screening and intervention in 500 000 pregnant women in Shenzhen, the People’s Republic of China , 2007, Sexually Transmitted Infections.

[2]  N. Thuy,et al.  Herpes simplex virus 2 infection in women attending an antenatal clinic in Fuzhou, China , 2007, Sexually Transmitted Infections.

[3]  Xiangsheng Chen,et al.  Congenital syphilis in China – Authors' reply , 2007, The Lancet.

[4]  Myron S. Cohen,et al.  Syphilis in China: results of a national surveillance programme , 2007, The Lancet.

[5]  B. Stanton,et al.  HIV-Related Risk Behaviors and History of Sexually Transmitted Diseases Among Male Migrants Who Patronize Commercial Sex in China , 2007, Sexually transmitted diseases.

[6]  林丽君,et al.  Risk factors in association with congenital syphilis: a case control study , 2006 .

[7]  Myron S. Cohen,et al.  China’s Syphilis Epidemic: A Systematic Review of Seroprevalence Studies , 2006, Sexually transmitted diseases.

[8]  Xiu-yun Wang,et al.  [An intervention study on preventing maternal-fetal transmission of syphilis during pregnancy]. , 2006, Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi.

[9]  N. Thuy,et al.  Sexually Transmitted Infections Among Pregnant Women Attending an Antenatal Clinic in Fuzhou, China , 2006, Sexually transmitted diseases.

[10]  B. Stanton,et al.  HIV-related sexual behaviour among migrants and non-migrants in a rural area of China: role of rural-to-urban migration. , 2006, Public health.

[11]  R. Detels,et al.  Sexual behavior among employed male rural migrants in Shanghai, China. , 2006, AIDS education and prevention : official publication of the International Society for AIDS Education.

[12]  Cai Yu-ma Risk factors in association with congenital syphilis: a case control study , 2006 .

[13]  B. Arroll,et al.  High rates of chlamydia in patients referred for termination of pregnancy: treatment, contact tracing, and implications for screening. , 2005, The New Zealand medical journal.

[14]  Xinguang Chen,et al.  Risk factors for sexually transmitted disease among rural-to-urban migrants in China: implications for HIV/sexually transmitted disease prevention. , 2005, AIDS patient care and STDs.

[15]  Chen Qing-shan Analysis on the Epidemiololgy of Syphilis from 1984 to 2003 in Shenzhen , 2005 .

[16]  B. Stanton,et al.  HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China. , 2004, AIDS education and prevention : official publication of the International Society for AIDS Education.

[17]  Zhongdong Ma,et al.  China's Floating Population: New Evidence from the 2000 Census , 2004 .

[18]  L. Bin STATUS OF PREGNANCY COMPLICATED SYPHILIS IN SHENZHEN , 2004 .

[19]  Z. Hua Epidemiological Analysis of Syphilis Transmition in Pregnant Women in Baoan District, Shenzhen City During 1999 to 2002 , 2004 .

[20]  E. Laumann,et al.  Population-based study of chlamydial infection in China: a hidden epidemic. , 2003, JAMA.

[21]  S. M. Chen,et al.  Prevalence of and risk indicators for STIs among women seeking induced abortions in two urban family planning clinics in Shandong province, People's Republic of China , 2002 .

[22]  P. Simmons Handbook on Sexually Transmitted Diseases , 1979 .