Syphilis follow-up.

Objectives
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.
Methods
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.
Results
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.
Conclusions
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.