Social Factors Associated With Congenital Syphilis in Missouri

Area of Science:

• Public Health
• Maternal and Child Health
• Social Epidemiology

Background:

• Congenital syphilis disproportionately affects populations facing social determinants of health.
• Understanding these determinants is key to providing comprehensive care for affected mother-infant dyads.

Purpose of the Study:

• To investigate the association between social determinants of health and congenital syphilis outcomes.
• To identify specific social factors contributing to congenital syphilis in a hospital system.

Main Methods:

• Retrospective review of 131 mother-infant dyads with potential congenital syphilis (2015-2022).
• Classification of cases based on Centers for Disease Control and Prevention criteria.
• Comparison of dyads with congenital syphilis outcomes versus non-congenital syphilis outcomes, analyzing demographics, prenatal care, substance use, and social factors.

Main Results:

• 74 dyads had congenital syphilis outcomes; 56 had non-congenital syphilis outcomes.
• Mothers were predominantly Black/African American and resided in high Social Vulnerability Index areas.
• Significant associations with congenital syphilis included inadequate/no prenatal care, substance use, housing instability, and justice system involvement.

Conclusions:

• Adverse social determinants of health are prevalent in congenital syphilis cases.
• Health systems should implement interdisciplinary programs for improved testing and care linkage.
• Further research on social support for congenital syphilis prevention and management is recommended.