Maternal risk factors for congenital syphilis: a case-control study

Area of Science:

• Obstetrics and Gynecology
• Pediatrics
• Infectious Diseases

Background:

• Congenital syphilis poses a significant threat to newborns.
• Maternal substance use, including cocaine, is a growing concern in pregnancy.
• The interplay between prenatal care access and substance use in predicting congenital syphilis requires further investigation.

Purpose of the Study:

• To estimate the association between maternal cocaine use and congenital syphilis.
• To adjust for confounding factors, particularly prenatal care utilization.
• To compare the predictive strength of maternal cocaine use versus lack of prenatal care for congenital syphilis.

Main Methods:

• Retrospective chart and laboratory data review of infants treated for congenital syphilis and matched controls.
• Assessment of maternal cocaine use via medical histories and infant toxicology screenings.
• Multiple logistic regression analysis to determine adjusted odds ratios for risk factors.

Main Results:

• Infants with congenital syphilis showed significantly higher in utero cocaine exposure (66.2%) compared to controls (16.1%).
• Lack of prenatal care emerged as the strongest predictor (adjusted OR = 11.0).
• Maternal cocaine use was also a significant predictor (adjusted OR = 4.9), but secondary to prenatal care access.

Conclusions:

• Underutilization of prenatal care is the most potent predictor of congenital syphilis.
• While maternal cocaine use is an emerging risk factor, ensuring access to and utilization of prenatal care is crucial for prevention.
• Public health strategies should prioritize comprehensive prenatal care to mitigate congenital syphilis rates.