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Analysis of Maternal and Congenital Syphilis Rates at a New Jersey University Hospital
Paige Heiman1, Vineet Bhandari1,2, Sarah Davenport3,4
1Cooper Medical School of Rowan University, Camden, NJ 08103, USA.
Insights
Congenital syphilis (CS) rates are rising, exacerbated by the COVID-19 pandemic. Improvements in prenatal care and timely maternal syphilis treatment are crucial to reduce transmission and improve outcomes.
Area of Science:
- Public Health
- Infectious Diseases
- Maternal-Fetal Medicine
Background:
- Syphilis and congenital syphilis (CS) rates have been increasing globally since the 2000s.
- Social determinants and the COVID-19 pandemic may be contributing factors to rising syphilis transmission.
Purpose of the Study:
- To quantify the rise in CS rates at a large urban hospital.
- To assess the impact of the COVID-19 pandemic on CS rates.
Main Methods:
- Retrospective chart review of 61 pregnant women diagnosed with syphilis.
- Data collected from January 2016 to June 2022 at an urban academic hospital.
Main Results:
- Maternal syphilis and CS rates significantly increased over the study period, especially around the COVID-19 pandemic.
- Inadequate prenatal care, screening, and treatment were observed in a significant proportion of mothers.
- Homelessness and past opioid use were associated with increased CS risk.
- Stillbirth occurred in 6.6% of pregnancies; 97.6% of liveborn infants received appropriate treatment, but only 45.1% had adequate follow-up.
Conclusions:
- Maternal syphilis and CS rates have risen at the study hospital, with a notable increase during the COVID-19 pandemic.
- Gaps in prenatal care access and timely maternal treatment require targeted interventions.
- Addressing social factors like homelessness and opioid use is essential for CS prevention.
Abstract:
Syphilis and congenital syphilis (CS) cases have been rising in the U.S. and internationally since the 2000s. Social factors have been shown to increase the risk of CS transmission. The COVID-19 pandemic may have contributed to increased syphilis transmission. We aimed to quantify the rise in congenital syphilis (CS) rates at a large urban hospital and the impact of the COVID-19 pandemic on CS rates. We completed a retrospective chart review of 61 pregnant women with a positive test or previous diagnosis of syphilis at an urban academic hospital between 1 January 2016 and 1 June 2022. Maternal syphilis and CS rates increased over the 5 years (p < 0.001), particularly pre- and post-COVID-19 (p < 0.001). Of the mothers studied, 34.6% received adequate prenatal care, 62.7% received adequate screening, and 81.3% received adequate treatment. Stillbirth was noted in 6.6% of pregnancies. Of liveborn infants, 97.6% received appropriate treatment, and 45.1% received adequate follow-up. CS development was significantly associated with homelessness (p = 0.028) and past opioid use (p = 0.031). We concluded that maternal syphilis and CS rates have increased at our hospital, particularly during the COVID-19 pandemic. Access to prenatal care and timely maternal treatment are target areas for improvement.
