Outcomes of infants born to pregnant women with syphilis: a nationwide study in Korea
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Abstract
BACKGROUND: Despite the expansion of antenatal syphilis screening programs, congenital syphilis (CS) remains a concern. PURPOSE: This study aimed to analyze the manifestation and progress of CS, including treatment and follow-up, based on a nationwide study. METHODS: From the Korean National Health Insurance Service database, a total of 548 infants were examined for CS during their first year of life from 2013 to 2018. Neurosyphilis and complications were investigated using the International Classification of Diseases-10 codes. RESULTS: The birth rate of infants from mothers with syphilis was 2.8 per 10,000 live births for 5 years, which is not indicative of a decreasing trend. Overall, 148 infants were proven or highly probable or possible of having CS with treatment for 10 days; 66 infants were possible or less likely of having CS with only 1-day treatment. Jaundice (56 %) was common, followed by hearing impairment (14 %), renal disease (8 %), and mental retardation (8 %). Fourteen cases of neurosyphilis occurred. Infants with complications, including mental retardation, eye involvement, hearing impairment, or renal disease, were significantly associated with neurosyphilis (OR 8.49, P < 0.0001). Of 250 patients who received treatment, 92.8 % were treated with one medication: benzathine penicillin was used in 73 % of patients. Only four patients were re-treated due to treatment failure. In addition to the treponemal test, fluorescent treponemal antibody-absorption was the most utilized tool for diagnosis and follow-up. CONCLUSIONS: Establishing standardized guidelines for the evaluation of CS, as well as the establishment of treatment regimens and follow up-plans for the disease, at a national level would help improve maternal and neonatal care and facilitate the eradication of CS in Korea.
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Between 2.5% and 27% of neonates with congenital syphilis may have central nervous system (CNS) involvement.
“Between 2.5% and 27% of neonates with congenital syphilis may have central nervous system (CNS) involvement 41-43.”
From Efectividad del tratamiento de la sífilis gestacional en el último trimestre sobre la incidencia de sífilis congénita: revisión sistemática y metanálisis (2025) · cites this paper as [41]
The Discussion reports neurosyphilis in 14 infants (2.5%), supporting the lower figure as a measure of CNS involvement. But the study evaluated infants born to mothers with syphilis, not solely neonates with confirmed congenital syphilis, and it does not report a 27% CNS-involvement rate. The 26.6 in the Results is the upper limit of a confidence interval for an odds ratio, not a percentage. (LLM, conf=0.87)
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- Authors
- Lim, J., Yoon, S. J., Shin, J. E., Han, J. H., Lee, S. M., Eun, H. S., Park, M. S., & Park, K. I.
- Affiliations
- Yonsei University (KR)
- Corresponding author
- Lee, Soon Min
- ORCID
- Venue
- BMC Pediatrics
- Published
- 2021-01-22
- Volume
- 21
- Issue
- 1
- Pages
- 47-47
- ISSN
- 1471-2431 (ISSN-L)
- PMC
- PMC7821395
- OpenAlex
- W3101629410
- Cited by
- 43
- References
- 28
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 19 · 2023: 10 · 2022: 3 · 2021: 1
- FWCI
- 5.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Pediatrics (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Funders
- Yonsei University College of Medicine (6-2016-0125)
- Topics
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
- Keywords
- congenital syphilis, maternal syphilis, neurosyphilis, infant outcomes, benzathine penicillin, treatment failure, jaundice, hearing loss, intellectual disability, kidney disease, treponemal tests, antenatal syphilis screening, Korea
- MeSH terms
- Female, Humans, Infant, Infant, Newborn, Pregnancy, Pregnancy Complications, Infectious, Syphilis, Syphilis, Congenital, Pregnant People, Republic of Korea
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