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We evaluated effects of HIV\/syphilis coinfection in pregnancy on birth outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted 2 prospective birth cohort studies in Uganda from 2017 to 2023. Our primary outcome was birthweight. Our secondary outcome was a composite adverse birth outcome (birthweight &amp;lt;2.5 kg, stillbirth, early neonatal death, or 5-min APGAR&amp;lt;7). We compared outcomes by HIV and Treponema pallidum particle agglutination assay (TPPA) seropositivity and fitted multivariable regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Treponema pallidum particle agglutination assay seroprevalence was 12% (118\/967); 19% (94\/483) among WHIV and 5% (24\/484) among women without HIV. Only 48% of TPPA-seropositive women reported syphilis testing during antenatal care. Stillbirth and early neonatal death were higher among TPPA seropositive (12%, 15\/118) than seronegative (4%, 32\/849) participants. Low birthweight was associated with HIV seropositivity (\u22120.1 kg, 95% CI \u22120.15, \u22120.04), younger maternal age (0.01 kg per year, 95% CI 0.01, 0.02), and lower gestational age (0.07 kg per week, 95% CI 0.06, 0.09) but not TPPA serostatus. The composite outcome was associated with lower maternal and gestational age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We report high TPPA seroprevalence, low syphilis testing rates, and associations with adverse birth outcomes, emphasizing the need to improve prenatal syphilis testing and treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf453","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:41:56Z","timestamp":1756294916000},"page":"197-205","source":"Crossref","is-referenced-by-count":2,"title":["HIV and Syphilis Coinfection in Pregnancy and Adverse Birth Outcomes in Uganda"],"prefix":"10.1093","volume":"233","author":[{"given":"Mehal","family":"Churiwal","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anacret","family":"Byamukama","sequence":"additional","affiliation":[{"name":"Kabwohe Clinical Research Centre , Kabwohe ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4255-2818","authenticated-orcid":false,"given":"Edna","family":"Tindimwebwa","sequence":"additional","affiliation":[{"name":"Kabwohe Clinical Research Centre , Kabwohe ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Chitneni","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Massachusetts General Hospital Center for Global Health , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Global Health Equity and General Internal Medicine, Brigham and Women's Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Adong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Mbarara University of Science and Technology , Mbarara ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Kumbakumba","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Mbarara University of Science and Technology , Mbarara ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Asiimwe","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Mbarara University of Science and Technology , Mbarara ,","place":["Uganda"]},{"name":"Africa Health Research Institute , Durban ,","place":["South Africa"]},{"name":"Kabwohe Clinical Research Centre , Kabwohe 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