Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality

Table 1 Quality assessment of evidence for treatment with at least 2.4MU penicillin for women with active syphilis in pregnancy to prevent adverse pregnancy and neonatal outcomes:

	Quality Assessment						Summary of Findings
					Directness			Treated women with active syphilis		Untreated women with active syphilis
No of studies (ref)	Intervention	Design	Limitations	Consistency	Generalizability to population of interest	Generalizability to intervention of interest	GRADE of evidence	Number events	Number of births	Number events	Number of births	Effect size (95% CI)
*Stillbirths:*
8	At least 2.4MU penicillin	Observational studies	no or insufficient controlling for important potential confounding variables	Consistent	Yes	Yes	Low	70	2578	185	1353	RR= 0.18* (0.10 - 0.33)
*PerinatalMortality (stillbirth and early neonatal mortality):*
2	At least 2.4MU penicillin	Cohort studies	Both from South Africa	Consistent	Both from South Africa	Yes	Low	39	952	19	233	RR= 0.49 - 0.65
*Neonatal Mortality (All Cause):*
5	At least 2.4MU penicillin	Observational studies	no or insufficient controlling for important potential confounding variables	Consistent	Yes	Yes	Low	29	2068	62	972	RR=0.20* (0.13 - 0.32)
*Preterm birth:*
7	At least 2.4MU penicillin	Observational studies	no or insufficient controlling for important potential confounding variables	Consistent	Yes	Yes	Low	85	947	250	1012	RR=0.36* (0.27 - 0.47)
*Congenital syphilis:*
3	At least 2.4MU penicillin	Observational studies	no or insufficient controlling for important potential confounding variables but as very specific outcome unlikely to be confounded	Consistent	Yes	Yes	Moderate	20	2745	139	715	RR=0.03* (0.02 - 0.07)

ISSN: 1471-2458