Maternal syphilis not only seriously affects the quality of life of pregnant women themselves but also may cause various adverse pregnancy outcomes (APOs). This study aimed to analyse the association between the related factors and APOs in maternal syphilis. 7,030 pregnant women infected with syphilis in Henan Province between January 2016 and December 2022 were selected as participants. Information on their demographic and clinical characteristics, treatment status, and pregnancy outcomes was collected. Multivariate logistic regression models and chi-squared automatic interaction detector (CHAID) decision tree models were used to analyse the factors associated with APOs. The multivariate logistic regression results showed that the syphilis infection history (OR = 1.207, 95% CI, 1.035–1.409), the occurrence of abnormality during pregnancy (OR = 5.001, 95% CI, 4.203–5.951), not receiving standard treatment (OR = 1.370, 95% CI, 1.095–1.716), not receiving any treatment (OR = 1.313, 95% CI, 1.105–1.559), and a titre ≥1:8 at diagnosis (OR = 1.350, 95%CI, 1.079–1.690) and before delivery (OR = 1.985, 95%CI, 1.463–2.694) were risk factors. A total of six influencing factors of APOs in syphilis-infected women were screened using the CHAID decision tree model. Integrated prevention measures such as early screening, scientific eugenics assessment, and standard syphilis treatment are of great significance in reducing the incidence of APOs for pregnant women infected with syphilis.

Pregnancy is a complex biological process. The establishment and maintenance of foetal–maternal interface are pivotal events. Decidual immune cells and inflammatory cytokines play indispensable roles in the foetal–maternal interface. The disfunction of decidual immune cells leads to adverse pregnancy outcome. Tumour necrosis factor (TNF)-α, a common inflammatory cytokine, has critical roles in different stages of normal pregnancy process. However, the relationship between the disorder of TNF-α and adverse pregnancy outcomes, including preeclampsia (PE), intrauterine growth restriction (IUGR), spontaneous abortion (SA), preterm birth and so on, is still indefinite. In this review, we thoroughly reviewed the effect of TNF-α disorder on pathological conditions. Moreover, we summarized the reports about the adverse pregnancy outcomes (PE, IUGR, SA and preterm birth) of using anti-TNF-α drugs (infliximab, etanercept and adalimumab, certolizumab and golimumab) currently in the clinical studies. Overall, IUGR, SA and preterm birth are the most common adverse pregnancy outcomes of anti-TNF-α drugs. Our review may provide insight for the immunological treatment of pregnancy-related complication, and help practitioners make informed decisions based on the current evidences.

Globally, human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) continues to be a major public health issue. With improved survival, the number of people living with HIV/AIDS is increasing, with over 2 million among pregnant women. Investigating adverse pregnant outcomes of HIV-infected population and associated factors are of great importance to maternal and infant health. A cross-sectional data collected from hospital delivery records of 4397 mother–infant pairs in southwestern China were analysed. Adverse pregnant outcomes (including low birthweight/preterm delivery/low Apgar score) and maternal HIV status and other characteristics were measured. Two hundred thirteen (4.9%) mothers were HIV positive; maternal HIV infection, rural residence and pregnancy history were associated with all three indicators of adverse pregnancy outcomes. This research suggested that maternal population have high prevalence in HIV infection in this region. HIV-infected women had higher risks of experiencing adverse pregnancy outcomes. Rural residence predisposes adverse pregnancy outcomes. Findings of this study suggest social and medical support for maternal-infant care needed in this region, selectively towards rural areas and HIV-positive mothers.