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Early Childhood Neurodevelopmental Outcomes in Infants Exposed to Infectious Syphilis In Utero
Valsan P Verghese1, Leonora Hendson2, Ameeta Singh3,4
1From the Department of Pediatrics, Christian Medical College, Vellore, India.
Insights
Infants exposed to syphilis in utero face high risks of neurodevelopmental impairment, regardless of congenital syphilis. All exposed infants require neurodevelopmental assessments and early intervention services.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Infectious Diseases
Background:
- Limited data exist on neurodevelopmental outcomes for infants exposed to syphilis during gestation.
- Syphilis infection in pregnancy poses significant risks to fetal development.
Purpose of the Study:
- To investigate the neurodevelopmental outcomes of infants exposed to syphilis in utero.
- To compare outcomes between infants with and without congenital syphilis.
Main Methods:
- An inception cohort study was conducted in Edmonton, Canada (2002-2010).
- Infants born to mothers with reactive syphilis serology were identified and followed.
- Neurodevelopmental assessments were performed on surviving infants.
Main Results:
- Of 39 births, 30 survived; 11 had congenital syphilis, 7 did not.
- Neurodevelopmental impairment occurred in 27% of infants with congenital syphilis and 14% without.
- Speech and language delays were observed in 36% with congenital syphilis and 42% without.
Conclusions:
- Infants exposed to syphilis in utero are at elevated risk for neurodevelopmental issues.
- Neurodevelopmental assessments and early services are recommended for all exposed infants, irrespective of congenital syphilis diagnosis.
Background:
There are minimal neurodevelopmental follow-up data for infants exposed to syphilis in utero.
Methods:
This is an inception cohort study of infants exposed to syphilis in utero. We reviewed women with reactive syphilis serology in pregnancy or at delivery in Edmonton (Canada), 2002 through 2010 and describe the neurodevelopmental outcomes of children with and without congenital syphilis.
Results:
There were 39 births to women with reactive syphilis serology, 9 of whom had late latent syphilis (n = 4), stillbirths (n = 2) or early neonatal deaths (n = 3), leaving 30 survivors of which 11 with and 7 without congenital syphilis had neurodevelopmental assessment. Those with congenital syphilis were all born to women with inadequate syphilis treatment before delivery. Neurodevelopmental impairment was documented in 3 of 11 (27%) infants with congenital syphilis and one of 7 (14%) without congenital syphilis with speech language delays in 4 of 11 (36%) with congenital syphilis and 3 of 7 (42%) without congenital syphilis.
Conclusions:
Infants born to mothers with reactive syphilis serology during pregnancy are at high risk for neurodevelopmental impairment, whether or not they have congenital syphilis, so should all be offered neurodevelopmental assessments and early referral for services as required.
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