Background: Syphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously studies showed inconsistent results, and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia, and second, to assess its associated factors.

Methods: A comprehensive search was made on PubMed, Google scholar, Science Direct and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I² statistics and Egger’s regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively.

Result: We identified 15 suitable studies in this analysis. Accordingly, the overall pooled prevalence of syphilis among pregnant women in Ethiopia was 2.42% (95% CI; 1.79-3.04). Subgroup analysis indicated that 4.06% (95% CI; 2.86-5.26) in SNNP, 2.90% (95% CI; 1.55-4.25) in Addis Ababa, 2.22% (95% CI; 1.62-2.83) in Amhara and 1.46% (95% CI; 0.69-2.23) in Oromia region. Being married (OR: 0.37 (95% CI; 0.16–0.87%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR: 2.98 (95% CI; 1.15-7.70)) and women with history of previous sexually transmitted disease (STD) (OR: 5.29 (95% CI; 2.82-9.92)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV co-infection was 0.80% (95% CI; 0.60-1.01%).

Conclusion: This study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations.

Study protocol registration: CRD42020211650.

Key words: syphilis, sero-prevalence, pregnant women, meta-analysis, Ethiopia