Outcome of infants born to pregnant women with syphilis: A nationwide study in Korea

Abstract

BackgroundAlthough expansion of antenatal syphilis screening programs, congenital syphilis (CS) is still remaining issue. This study aimed to analyze the manifestation and progress of CS including treatment and follow-up based on nationwide study.MethodsFrom the Korean National Health Insurance Service database, a total of 548 infants were examined for CS during first year of life from 2013 to 2018. Neurosyphilis and complications were investigated using International Classification of Diseases-10 codes.ResultsThe birth rate from mother with syphilis was 2.8 per 10,000 live birth for 5 years, not showing tendency to decrease. One hundred forty-eight infants were proven or highly probable or possible for CS with treatment over 10 days. Sixty-six infants were possible or less likely CS with only 1-day treatment. Jaundice (56%) was most common and hearing impairment (14%), renal disease (8%), mental retardation (8%) followed. Total of 14 cases of neurosyphilis occurred. Patients who have complications such as mental retardation, eye involvement, hearing impairment and renal disease were significantly associated with neurosyphilis (OR 8.49, P < 0.0001). Among 250 patients with treatment, 92.8% was treated with 1 medication; Benzathine penicillin G was more used (72.4%) than aqueous crystalline penicillin G. Only 4 patients were retreated due to treatment failure. In addition to the treponemal test, fluorescent treponemal antibody-absorption was the most prescribed tool of diagnosis for follow up.ConclusionSharing a standardized guideline for evaluation and treatment regimens and follow up plan at a national level is needed for maternal neonatal care leading to eradication of CS.