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Characteristics associated with delivery of an infant with congenital syphilis and missed opportunities for prevention—California, 2012 to 2014.
Abstract
BACKGROUND: Congenital syphilis (CS), the transmission of Treponema pallidum from mother to fetus during pregnancy, can cause adverse birth outcomes. In 2012 to 2014, the CS rate in California increased more than 200% from 6.6 to 20.3 cases per 100,000 live births. Our objectives were to identify characteristics associated with delivering an infant with CS and missed opportunities for prevention among syphilis-infected pregnant women in California. METHODS: We linked California Department of Public Health syphilis surveillance records from women aged 15 to 45 years-diagnosed from March 13, 2012, to December 31, 2014-to birth records. We compared characteristics among mothers who delivered an infant with CS (CS mothers) with mothers who delivered an infant without CS (non-CS mothers) by using χ or Fisher exact tests. To visualize gaps in prevention among syphilis-infected pregnant women, we constructed a CS prevention cascade, a figure that shows steps to prevent CS. RESULTS: During the selected period, 2498 women were diagnosed as having syphilis, and 427 (17%) linked to birth records; 164 (38%) were defined as CS mothers and 263 (62%) as non-CS mothers. Mothers with CS were more likely than non-CS mothers to have their first prenatal care visit in the third trimester. High proportions of mothers in both groups reported high-risk sexual behaviors, methamphetamine use, or incarceration (13%-29%). The CS prevention cascade showed decrements of 5% to 11% in prenatal care receipt, testing, and treatment steps; only 62% of potential CS births were prevented. CONCLUSIONS: Multifaceted efforts are needed to address gaps in the CS prevention cascade and reduce CS cases in California.
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“Maternal risk factors for syphilis during pregnancy include sex with multiple partners, sex in conjunction with drug use or transactional sex, late entry to prenatal care (i.e., first visit during the second trimester or later) or no prenatal care, methamphetamine or heroin use, incarceration of the woman or her partner, and unstable housing or homelessness (174,633–636).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [633]
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Cites
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Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 3,018
Missed opportunities for prevention of congenital syphilis—United States, 2018.
Kimball, A., Torrone, E., Miele, K., Bachmann, L., Thorpe, P., Weinstock, H., & Bowen, V. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6922a1 · Cited by 163
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Maternal and perinatal risk factors associated with congenital syphilis
Pascoal, L. B., Carellos, E. V. M., Tarabai, B. H. M., Vieira, C. C., Rezende, L. G., Salgado, B. S. F., & Romanelli, R. M. D. C. (2023) · Tropical Medicine & International Health · doi:10.1111/tmi.13881 · Cited by 69
Chan, E. Y. L., Smullin, C. P., Clavijo, S., Papp-Green, M., Park, E. V., Nelson, M., Giarratano, G., & Wagman, J. A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0249419 · Cited by 50
Metadata
- Authors
- Biswas, H. H., Chew Ng, R. A., Murray, E. L., Chow, J. M., Stoltey, J. E., Watt, J. P., & Bauer, H. M.
- Affiliations
- Centers for Disease Control and Prevention (US)
- California Department of Public Health, Richmond, CA
- California Department of Public Health (US)
- Corresponding author
- Biswas, Hope H.
- Venue
- Sexually Transmitted Diseases
- Published
- 2018-07
- Volume
- 45
- Issue
- 7
- Pages
- 435-441
- ISSN
- 0148-5717 (ISSN-L)
- 1537-4521
- OpenAlex
- W2781612218
- Cited by
- 44
- References
- 11
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 7 · 2023: 5 · 2022: 9 · 2021: 5 · 2020: 5 · 2019: 2 · 2018: 3
- FWCI
- 2.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sexually Transmitted Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Syphilis Diagnosis and Treatment
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- congenital syphilis, Treponema pallidum, prenatal care, missed opportunities for prevention, maternal syphilis, prenatal testing, methamphetamine use, incarceration, sexual risk behavior, California
- MeSH terms
- Adolescent, Adult, California, Female, Humans, Infant, Newborn, Medical Records, Middle Aged, Mothers, Pregnancy, Pregnancy Complications, Infectious, Prenatal Care, Prenatal Diagnosis, Public Health, Syphilis, Syphilis, Congenital, Treponema pallidum, Infectious Disease Transmission, Vertical, Young Adult
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