Cited by 73Syphilis Diagnosis and TreatmentReproductive tract infections researchMaternal and Neonatal Healthcare

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Social vulnerability in congenital syphilis case mothers: qualitative assessment of cases in Indiana, 2014 to 2016.

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DiOrio, Dawne, Kroeger, Karen, Ross, Amara·2018·Sexually Transmitted Diseases

DOI 10.1097/olq.0000000000000783PMC PMC5995623

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Abstract

BACKGROUND: Congenital syphilis occurs when a pregnant woman with syphilis is not diagnosed or treated and the infection is passed in utero, causing severe infant morbidity and mortality. Congenital syphilis is easily prevented if women receive timely and adequate prenatal care. Cases of congenital syphilis are considered indicators of problems in the safety net. However, maternal social and behavioral factors can impede women's care, even when providers follow guidelines. METHODS: We reviewed case interviews and maternal records for 23 congenital syphilis cases reported to the Centers for Disease Control and Prevention from Indiana between 2014 and 2016. We used qualitative methods to analyze narrative notes from maternal interviews to learn more about factors that potentially contributed to congenital syphilis cases. RESULTS: All providers followed Centers for Disease Control and Prevention and state recommendations for screening and treatment for pregnant women with syphilis. Twenty-one of 23 women had health insurance. The number of prenatal care visits women had was suboptimal; more than one third of women had no prenatal care. Nearly one third of women's only risk factor was sex with a primary male sex partner. The majority of women suffered social vulnerabilities, including homelessness, substance abuse, and incarceration. CONCLUSIONS: Despite provider adherence to guidelines and health insurance availability, some pregnant women with syphilis are unlikely to receive timely diagnosis and treatment. Pregnant women at high risk for syphilis may need additional social and material support to prevent a congenital syphilis case. Additional efforts are needed to reach the male partners of vulnerable females with syphilis.

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Additional file 2 of Congenital syphilis in East Baton Rouge parish, Louisiana: providers’ and women’s perspectives
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Additional file 1 of Congenital syphilis in East Baton Rouge parish, Louisiana: providers’ and women’s perspectives
Harville, E. W., Giarratano, G., Buekens, P. M., Lang, E. M., & Wagman, J. A. (2021) · Figshare · doi:10.6084/m9.figshare.13565627
Additional file 1 of Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California
Park, E., Yip, J., Harville, E. W., Nelson, M., Giarratano, G., Buekens, P. M., & Wagman, J. A. (2022) · Figshare · doi:10.6084/m9.figshare.19129003
Additional file 2 of Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California
Park, E., Yip, J., Harville, E. W., Nelson, M., Giarratano, G., Buekens, P. M., & Wagman, J. A. (2022) · Figshare · doi:10.6084/m9.figshare.19129006
Preventing Congenital Syphilis Through Evidence-Based Clinical Bundles in Community Settings
Martinot, K. H., Reifsnider, E., Daniels, J., Manis, D. R., & Muzny, C. A. (2026) · Nursing for Women s Health · doi:10.1016/j.nwh.2026.02.002
Gestational syphilis and prenatal care: a study in light of individual, social, and programmatic vulnerabilities
Sarefino, A. D. O., Queiroz, A. B. A., Silva, K. G., Souza, N. V. D. D. O., Titara, N. M. L., Carvalho, A. R., Bezerra, J. D. F., Pinheiro, A. K. C., & da Rosa, A. F. (2026) · Revista da Escola de Enfermagem da USP · doi:10.1590/1980-220x-reeusp-2025-0270en
Sífilis gestacional e acompanhamento pré-natal: um estudo frente às vulnerabilidades individuais, sociais e programáticas
Sarefino, A. D. O., Queiroz, A. B. A., Silva, K. G., Souza, N. V. D. D. O., Titara, N. M. L., Carvalho, A. R., Bezerra, J. D. F., Pinheiro, A. K. C., & da Rosa, A. F. (2026) · Revista da Escola de Enfermagem da USP · doi:10.1590/1980-220x-reeusp-2025-0270pt
PREnatal Syphilis point-of-care ScreenING in an urban low-barrier clinic (PRESSING) study: Protocol for a prospective single arm feasibility trial
Sanya, N., Vaccaro, M.-E., Uppal, M., Glen, S., Kirkby, C., Zafar, T., Gasparelli, J., MacNeil, K., Milliken, S., Pernica, J. M., et al. (2026) · PLoS ONE · doi:10.1371/journal.pone.0360150

Authors: DiOrio, D., Kroeger, K., & Ross, A.
Affiliations: Centers for Disease Control and Prevention (US)
Indiana State Department of Health (US)
Corresponding author: DiOrio, Dawne
ORCID: DiOrio, Dawne
Venue: Sexually Transmitted Diseases
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2018-07
Volume: 45
Issue: 7
Pages: 447-451
ISSN: 0148-5717 (ISSN-L)
1537-4521
DOI: 10.1097/olq.0000000000000783
PMC: PMC5995623
OpenAlex: W2782522072
Cited by: 73
References: 26
Citations by year: 2026: 6 · 2025: 7 · 2024: 9 · 2023: 8 · 2022: 11 · 2021: 18 · 2020: 8 · 2019: 3 · 2018: 3
FWCI: 5.50
Type: journal article
Language: en
Open access: green
europepmc.org
Locations: Sexually Transmitted Diseases (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (CC999999)
Topics: Health Sciences › Medicine › Infectious Diseases › Syphilis Diagnosis and Treatment
Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Keywords: congenital syphilis, prenatal care, syphilis screening in pregnancy, homelessness, substance abuse, incarceration, health insurance, safety net health care, Indiana
MeSH terms: Adolescent, Adult, Female, Ill-Housed Persons, Humans, Indiana, Mothers, Pregnancy, Pregnancy Complications, Infectious, Prenatal Care, Risk Factors, Social Conditions, Syphilis, Syphilis, Congenital, Vulnerable Populations, Young Adult, Health Records, Personal

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Social vulnerability in congenital syphilis case mothers: qualitative assessment of cases in Indiana, 2014 to 2016.

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