Risk factors for congenital syphilis in infants of women with syphilis in South Carolina.

Abstract

OBJECTIVES: This study examined risk factors for congenital syphilis in South Carolina. METHODS: Case infants with presumptive and confirmed congenital syphilis were compared with control infants born to women with reactive serologies during pregnancy, allowing investigation of risk factors for congenital rather than acquired transmission of syphilis. Data were collected from congenital syphilis report forms and birth certificates for 186 case infants and 487 controls born from 1991 to 1993. Odds ratios were calculated for maternal risk factors. RESULTS: Significant statistical trends were found for timing of first prenatal visit and number of visits. Other significant factors included rural residence (odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.4, 2.9) and previous pregnancy loss (OR = 0.3, 95% CI = 0.2, 0.6). CONCLUSIONS: Prevention of congenital syphilis may be less effective among pregnant women with syphilis in South Carolina who have fewer prenatal care visits. Health care providers need further education on maternal/child syphilis management and techniques for motivating and educating patients.

Opportunities for the Prevention of Congenital Syphilis in Maricopa County, Arizona

“…Similar to previous studies, most missed opportunities to prevent congenital syphilis in Maricopa County seem to be due to failure to receive prenatal syphilis testing due to lack of PNC 7 Tested positive and treated during pregnancy but response was equivocal or could not be determined from titer information 6 (5)…”

Missed opportunities for congenital syphilis and HIV perinatal transmission prevention

“…The failure to diagnose and treat syphilis early in the pregnancy may lead to fetal loss, premature delivery and congenital syphilis, many times asymptomatic and non-diagnosed. 5,9 Similarly, early HIV infection diagnosis with the use of antiretroviral drugs during pregnancy and labor and the use of zidovudine by the newborn may reduce the rates of vertical transmission to less than 2%. Sociodemographic variables associated to not being tested or being tested for VDRL or anti-HIV only indicate greater social vulnerability of the population studied: single women with low schooling and income.…”

“…Maternal syphilis may result in fetal and neonatal death, fetal hydropsy, intrauterine growth retardation, as well as preterm infants. 5,9 It is estimated that 40% of pregnancies in women with non-treated primary or secondary syphilis evolve into fetal loss or neonatal death. 4 In recent years, an increase in syphilis prevalence in developing and industrialized countries has been seen, especially primary and secondary syphilis in childbearing women, with a consequent increase in the rate of neonatal syphilis.…”

Examination of a prenatal syphilis screening program, Alberta, Canada: 2010–2011

“…We also examined women who had no PST documented (n = 1,447) together with those who had their first and only PST at the time of delivery (n = 1,492) and compared them to women with any PST testing prior to delivery (n = 96,670 4.2%, p < 0.0001 respectively) (data not shown). They were also more likely to have no prenatal care (39.2% vs. 2.0%, p < 0.0001) or to seek midwifery care (4.1% vs. 2.6%, p < 0.0001), and among those who sought physician prenatal care, women who had no or late testing were less likely to start physician care in the first trimester (37.8% vs. 64.3%, p < 0.0001).…”

“…1,2 Universal prenatal syphilis screening is recommended as one facet in the strategy for the elimination of congenital syphilis, 3 however there is limited literature on maternal characteristics associated with poor compliance with prenatal syphilis testing. Studies have shown that lack or late initiation of prenatal care, [4][5][6][7][8] single marital status, 5 tobacco, alcohol or drug use, 4,5,8 and rural residence 4 are associated with congenital syphilis infections and may represent factors associated with barriers to prenatal screening. In 2007, a syphilis outbreak was declared in the Canadian province of Alberta.…”