{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:53:05Z","timestamp":1777611185981,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100024710","name":"Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100024710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Infectious syphilis among women of reproductive age continues to rise in many countries including Australia, with a resultant increase in congenital syphilis. In response, new guidelines for management of syphilis in pregnancy were published in Queensland, Australia in 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study evaluates the management of women diagnosed with syphilis in pregnancy in South\u2010East Queensland (SEQ) after release of this guideline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This retrospective review of notification data identified women in SEQ who had a positive syphilis serology during pregnancy, without evidence of adequate treatment prior to the pregnancy, between January 2019 and December 2021 inclusive. Maternal demographics and pregnancy details including syphilis staging, testing and management were extracted, with management assessed against the 2018 Queensland syphilis in pregnancy guideline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 42 women identified, 79% were diagnosed in the first or second trimester, 69% had early\u2010stage syphilis at the time of diagnosis and 86% were asymptomatic at the time of diagnosis. All, including the eight (19%) Aboriginal and\/or Torres Strait Islander women identified, completed stage\u2010appropriate treatment with penicillin, 83% completed treatment four weeks prior to delivery and 60% achieved a four\u2010fold reduction in rapid plasma reagin at time of delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest compliance with syphilis in pregnancy management recommendations has improved in SEQ since release of the 2018 guidelines. However, congenital syphilis rates continue to rise; further initiatives addressing barriers to timely testing and management of syphilis in pregnancy are urgently needed at both healthcare system levels and for individual women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13902","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:34:06Z","timestamp":1732149246000},"page":"329-335","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Management of detected syphilis in pregnancy adheres to guideline recommendations, but the crisis of congenital syphilis persists"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9038-0593","authenticated-orcid":false,"given":"Aoife","family":"Moore","sequence":"first","affiliation":[{"name":"Queensland Children's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2513-2013","authenticated-orcid":false,"given":"Judith A.","family":"Dean","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1268-578X","authenticated-orcid":false,"given":"Diane","family":"Rowling","sequence":"additional","affiliation":[{"name":"Queensland Syphilis Surveillance Service (South) Metro North Public Health  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6465-3754","authenticated-orcid":false,"given":"Sumudu","family":"Britton","sequence":"additional","affiliation":[{"name":"Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5716-5250","authenticated-orcid":false,"given":"James A","family":"Fowler","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9149-1962","authenticated-orcid":false,"given":"Sarah","family":"Warzywoda","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huda","family":"Safa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Mater Mothers\u2019 Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1604-8060","authenticated-orcid":false,"given":"Mandy","family":"Wu","sequence":"additional","affiliation":[{"name":"Redcliffe Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Nourse","sequence":"additional","affiliation":[{"name":"Infection Management and Prevention Service Queensland Children's Hospital  Brisbane Queensland Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003808"},{"key":"e_1_2_8_3_1","first-page":"65","article-title":"The global crisis of congenital syphilis: vulnerable and disenfranchised women most at risk","volume":"13","author":"Moore A","year":"2023","journal-title":"Res Rep Neonatol"},{"key":"e_1_2_8_4_1","volume-title":"National Notifiable Diseases Surveillance System","author":"Department of Health","year":"2022"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51270"},{"key":"e_1_2_8_6_1","volume-title":"Notifications of Syphilis in Queensland 2022 Report","author":"Communicable Diseases Branch DoH","year":"2023"},{"key":"e_1_2_8_7_1","volume-title":"Syphilis","author":"Queensland Health","year":"2023"},{"key":"e_1_2_8_8_1","volume-title":"Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Routine Antenatal Assessment in the Absence of Pregnancy Complications","author":"RANZCOG","year":"2022"},{"key":"e_1_2_8_9_1","volume-title":"Western Australia Country Health Service. Antenatal and Postnatal Syphilis Screening Guideline","year":"2021"},{"key":"e_1_2_8_10_1","volume-title":"NSW Health Policy Directive: Syphilis in Pregnancy and Newborns. PD2023_029","author":"NSW Government","year":"2023"},{"key":"e_1_2_8_11_1","unstructured":"Queensland Clinical Guidelines.Guideline: Syphilis in Pregnancy. Guideline no. M18.44\u2010V1\u2010R23. Available from URL:https:\/\/www.health.qld.gov.au\/__data\/assets\/pdf_file\/0035\/736883\/g\u2010sip.pdf2023 2023."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH22193"},{"key":"e_1_2_8_13_1","volume-title":"Vital signs: missed opportunities for preventing congenital syphilis\u2014United States, 2022","author":"McDonald R","year":"2023"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH23119"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07100-3"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2023.100740"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31826ac25f"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13424"},{"key":"e_1_2_8_19_1","unstructured":"QC Guidelines.Guideline supplement: syphilis in pregnancy. Guideline No. M18.44\u2010V6\u2010R23. Queensland Health2023."},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.73"},{"key":"e_1_2_8_21_1","volume-title":"Syphilis Decision\u2010Making Tool. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) Website","author":"Australasian Society for HIV VHaSHMA","year":"2022"},{"key":"e_1_2_8_22_1","volume-title":"Australasian Society for Infectious Diseases (ASID). Management of Perinatal Infections","author":"ASID","year":"2022"},{"key":"e_1_2_8_23_1","volume-title":"STI Treatment Guidelines","author":"Centers for Disease Control and Prevention (CDC)","year":"2021"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415624059"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234043"},{"issue":"2","key":"e_1_2_8_26_1","first-page":"80","article-title":"Serologic cross\u2010reactivity of syphilis, yaws, and pinta","volume":"87","author":"Caprariis PJ","year":"2013","journal-title":"Am Fam Physician"},{"key":"e_1_2_8_27_1","unstructured":"Statistics.ABo. Queensland: Aboriginal and Torres Strait Islander Population Summary.2022[Accessed 21 March 2024]. Available from URL:https:\/\/www.abs.gov.au\/articles\/queensland\u2010aboriginal\u2010and\u2010torres\u2010strait\u2010islander\u2010population\u2010summary."},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51864"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51586"},{"key":"e_1_2_8_30_1","unstructured":"The Institute for Urban Indigenous Health.Birthing in our community (BiOC).2024. Available from URL:https:\/\/www.iuih.org.au\/our\u2010services\/health\u2010and\u2010wellbeing\u2010services\/birthing\u2010in\u2010our\u2010community\/?gad_source=1&gclid=Cj0KCQjw\u20105y1BhCARIsAAM_oKkzicFrrcMdcRGAZeSS4LyTuEHMHxsfbcG_7\u201039EWo7bltg4XIFkCMaArdOEALw_wcB2024."},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00061-9"},{"key":"e_1_2_8_32_1","unstructured":"The Australian nurse\u2010family partnership program (ANFPP). Available from URL:https:\/\/www.anfpp.com.au\/about2024.2024."},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja16.00854"},{"key":"e_1_2_8_34_1","volume-title":"Queensland Syphilis Action Plan 2023\u20132028","author":"Queensland Government","year":"2024"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T11:26:51Z","timestamp":1753183611000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,20]]},"references-count":33,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/ajo.13902"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13902","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,20]]},"assertion":[{"value":"2024-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}