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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:

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

  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)
  1. *Based on calculated pooled estimate