Patterns of Congenital Syphilis in a Large Public Hospital: Maternal Risk Factors and Infant Outcomes

Area of Science:

• Public Health
• Infectious Diseases
• Maternal-Child Health

Background:

• Congenital syphilis (CS) incidence has surged dramatically in the U.S. over the past decade.
• A significant increase in infants born with CS has been observed at a major Los Angeles public hospital.

Purpose of the Study:

• To analyze trends and risk factors associated with congenital syphilis diagnoses.
• To identify maternal characteristics linked to higher probabilities of CS in infants.

Main Methods:

• A retrospective case series was conducted using infant rapid plasma reagin test results from 2022-2023.
• Statistical analyses (chi-squared and Fisher exact tests) examined associations between maternal risk factors and CS diagnosis.

Main Results:

• Maternal syphilis affected 4.1% of live births, with 36% of infants born to mothers with syphilis having inadequately treated infections or reinfection concerns.
• Infants exposed to maternal syphilis often presented asymptomatic but showed laboratory and radiographic abnormalities.
• Maternal methamphetamine, cocaine, and opiate use, along with lack of prenatal care, were significantly associated with probable or possible CS diagnoses.

Conclusions:

• Maternal substance use and absence of prenatal care are critical risk factors for congenital syphilis.
• These findings emphasize the vulnerability of affected populations and guide future prevention efforts.
• Targeted interventions are crucial to reduce the burden of congenital syphilis.