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Published on: July 30, 2013
The resurgence of congenital syphilis: a cocaine-related problem
C G Sison1, E M Ostrea, M P Reyes
1Department of Pediatrics, Hutzel Hospital, Detroit, MI 48201, USA.
Insights
Maternal illicit drug use, particularly cocaine, is linked to a rise in congenital syphilis. This study found higher rates of syphilis in infants exposed to drugs in utero.
Area of Science:
- Neonatal Health
- Infectious Diseases
- Public Health
Background:
- Congenital syphilis is a serious concern, and understanding its risk factors is crucial for prevention.
- Maternal substance use during pregnancy poses significant risks to infant health.
- The resurgence of congenital syphilis necessitates investigation into contributing factors like maternal drug use.
Purpose of the Study:
- To examine the association between maternal illicit drug exposure and congenital syphilis in newborns.
- To determine if specific drugs, such as cocaine, are more strongly linked to congenital syphilis.
Main Methods:
- Meconium analysis was used to screen 1012 newborn infants for intrauterine exposure to illicit drugs.
- Maternal syphilis screening was performed using the rapid plasma reagin/fluorescent treponemal antibody, absorbed (RPR/FTA-ABS) test.
- Congenital syphilis diagnosis in infants followed Centers for Disease Control and Prevention (CDC) definitions.
Main Results:
- 44.3% of infants showed positive results for intrauterine drug exposure (cocaine, opiates, or cannabinoids).
- Maternal RPR/FTA-ABS positivity and congenital syphilis diagnoses were significantly higher in infants with positive drug screening results (p < 0.01).
- Infants with cocaine-positive results had a significantly higher incidence of positive maternal syphilis tests and congenital syphilis diagnoses (p < 0.01).
Conclusions:
- Maternal illicit drug use is significantly associated with an increased risk of congenital syphilis.
- Cocaine use by mothers is particularly linked to the resurgence of congenital syphilis in newborns.
- These findings highlight the importance of addressing maternal substance abuse to combat congenital syphilis.
Abstract:
The relationship of maternal illicit drug use to congenital syphilis was studied in a population of newborn infants (N = 1012) who were screened for intrauterine exposure to illicit drugs by meconium analysis and whose mothers were screened for syphilis by the rapid plasmin reagin fluorescent treponemal antibody, absorbed (RPR/FTA-ABS) test. The result of the meconium drug screening was positive in 449 (44.3%) infants: 401 (39.6%) screening results were positive for cocaine, 71 (7%) positive for opiate, and 31 (3.1%) positive for cannabinoid. The maternal RPR/FTA-ABS result was positive in 72 (7.1%) women, and congenital syphilis was diagnosed in 46 (4.5%) infants on the basis of Centers for Disease Control and Prevention definitions. The incidence of positive RPR/FTA-ABS result (10.5% vs 4.4%) and congenital syphilis (7% vs 2.5%) was significantly higher (p < 0.01) among infants with positive results compared with those with negative drug screening results. Similarly, the incidence of positive RPR/FTA-ABS (11% vs 4.6%) and congenital syphilis (8% vs 2.3%) was significantly (p < 0.01) higher among infants with cocaine-positive results compared with those with cocaine-negative results. We conclude that maternal illicit drug use, specifically cocaine, is significantly related to the resurgence of congenital syphilis among newborn infants.
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