prevalence of syphilis among pregnant women in China: a systematic review and meta-analysis

Syphilis is a serious sexually transmitted infection that can cause severe adverse pregnancy outcomes. This study aimed to estimate the pooled prevalence of syphilis among pregnant women in China using systematic review and meta-analysis. This systematic review and meta-analysis were conducted with the PRISMA guidelines. After developing search strategies and registering the study protocol in PROSPERO, we systematically searched Medline, PubMed, Embase, Wiley Online Library, China National Knowledge Infrastructure (CNKI), Wanfang, and Chongqing VIP (CQVIP) for relevant cross-sectional studies conducted in China and published between 2005 and 2024, without language restrictions. The pooled prevalence of syphilis infection was estimated using a random-effects model in STATA software (version 15.0). Results are reported as prevalence estimates with 95% confidence intervals (95% CI), and a p-value < 0.05 was considered statistically significant. Heterogeneity was assessed using the I² statistic and Q-test, and publication bias was evaluated using Egger’s and Begg’s tests, trim-and-fill, and funnel plots. A total of 29 studies involving 8,830,599 pregnant women were included. The overall pooled prevalence of syphilis was 0.46% (95% CI: 0.40%–0.52%). The subgroup analysis revealed regional variations, with the Eastern region showing the highest rate (0.55%), followed by the Western (0.38%) and Central (0.36%) regions. Subgroup analysis by publication period revealed that the prevalence decreased from 0.75% (2005–2010) to 0.34% (2021–2024); however, the decline was not statistically significant (p = 0.062). In recent years, the prevalence of syphilis has shown a declining trend in China, although significant regional disparities remain. Continued attention should be paid to high-risk regional populations.