Retrospective Cohort Study of Syphilis-Related Stillbirths in Winnipeg, Manitoba from 2017-2020.

Objective:Syphilis-related stillbirths (SRSBs) disproportionately affectmarginalized women with 11% of all local stillbirths having maternalsyphilis as a contributory factor in 2020. This study describes theincidence and perinatal factors associated with SRSB. Methods:This was a retrospective cohort study of all stillbirthsoccurring from 1 January 2017 to 31 December 2020, at a singletertiary-level referral hospital in Winnipeg, Manitoba. Cases thatmet criteria for SRSB were identified from hospital records andincluded in thefinal analysis. Maternal demographics,comorbidities, prenatal care attendance, sexually transmittedinfection testing, treatment, and diagnostic investigations at time ofstillbirth were collected from hospital charts using a standardizeddata collection form. Descriptive statistics were performed topresent the results. Results:The proportion of SRSB increased over the period of studyfrom 0%e11%. Eleven cases were identified as SRSB, withdiagnosis occurring intrapartum in 7 cases and antenatally in 4cases. Of the 4 antenatal cases, only 2 had identifiable treatmentresponses indicated by microbiological and pathology workup.Commonly identified risk factors for SRSB were homelessness,mental illness, substance use, sexually transmitted co-infections,and lack of prenatal care Conclusions:Cases of SRSB are rising in Winnipeg with 11% of allstillbirths having maternal syphilis as a contributory factor by 2020.SRSBs disproportionately affect marginalized women. Thedramatic and rapid changes in the epidemiology of syphilis inWinnipeg are likely shared by other Canadian regions and warrantincreased prevention strategies to improve outcomes 2024 The Society of Obstetricians and Gynaecologists of Canada/LaSociete des obstetriciens et gynecologues du Canada. Published byElsevier Inc. This is an open access article under the CC BY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/)