Retrospective cohort study of syphilis-related stillbirths in Winnipeg, Manitoba from 2017-2020.

Syphilis-related stillbirths disproportionately affect marginalized women with 11% of all local stillbirths having maternal syphilis as a contributory factor in 2020. This study describes the incidence of and perinatal factors associated with syphilis-related stillbirths (SRSB). This was a retrospective cohort study of all stillbirths occurring from January 1 The proportion of SRSB increased over the period of study from 0% to 11% . Eleven cases were identified as SRSB, with diagnosis occurring intrapartum in 7 cases and antenatally in 4 cases. Of the four antenatal cases, only two had identifiable treatment responses indicated by microbiological and pathology workup. Commonly identified risk factors to SRSB were homelessness, mental illness, substance use, sexually transmitted coinfections, and lack of prenatal care. Cases of SRSB are rising in Winnipeg with 11% of all stillbirths having maternal syphilis as a contributory factor by 2020. SRSBs disproportionately affect marginalized women. The dramatic and rapid changes in the epidemiology of syphilis in Winnipeg is likely shared by other Canadian regions and warrants increased prevention strategies to improve outcomes.

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