Factors Contributing to Congenital Syphilis Cases — New York City, 2010–2016

Slutsker, Jennifer Sanderson; Hennessy, Robin R.; Schillinger, Julia A.

doi:10.15585/mmwr.mm6739a3

Cited by 60 publications

(68 citation statements)

References 6 publications

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“…16 Regarding gaps in the elimination of the mother-to-child transmission of syphilis, our study showed that 41% of mothers had inadequate treatment, in which late or no antenatal care was the major cause. This is comparable with the study from the US, 11 in which the major contributing factor was late initiation of antenatal care and the proportion of mothers who did not receive prenatal care was 31%. As in another study, 17 the majority of our syphilis diagnosis occurred during the second and third trimester of pregnancy, which indicated late access to care.…”

Section: Discussionsupporting

confidence: 85%

“…The reasons why mothers did not attend antenatal care or why they attended late were not recorded in our study, so we could not determine the exact reasons that prevented mothers from accessing care. However, it could stem from structural barriers, as previously reported, such as the lack of health-care coverage, 11 difficulty seeking transportation to access care, 18 low maternal education, 16,19 low awareness of the importance of early pregnancy care in the mother, or lack of interest. 19 Another factor leading to inadequate treatment is when pregnant women had acquired syphilis during pregnancy from their partner, which accounted for 8% of cases in our study.…”

Section: Discussionmentioning

confidence: 94%

“…The probable congenital syphilis definition includes infants with clinical findings suggesting congenital syphilis (infant criteria), infants born to mother who had untreated or inadequately treated syphilis at delivery in accordance with CDC treatment guidelines 8 (maternal criteria), or both. 11…”

Section: Surveillance Case Definitionsmentioning

confidence: 99%

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Gaps in the elimination of congenital syphilis in a tertiary care center in Thailand

Anugulruengkitt

Yodkitudomying²,

Sirisabya

et al. 2020

Pediatrics International

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Background The World Health Organization has set a goal to eliminate mother‐to‐child transmission of syphilis to a target of <50 cases per 100 000 live births. This study aimed to determine the rate of congenital syphilis and identify gaps in prevention. Methods A retrospective chart review was conducted in a tertiary care center in Bangkok, Thailand. The study included all pregnant women with positive syphilis serology and their infants. All congenital syphilis cases were categorized according to Centers for Disease Control criteria. Results From 2013 to 2017, 69 syphilis‐infected pregnant women were included, with 30 congenital syphilis cases. The rate of congenital syphilis was 115 cases (95% CI 78–164) per 100 000 live births. The median (interquartile range) maternal age was 21 (18–32) years and 12 (17%) women had human immunodeficiency virus co‐infection. Regarding maternal treatment, 28 (41%) women had inadequate treatment due to 13 cases (19%) of late or no antenatal care, six cases (8%) of recent infection near delivery, five cases (7%) of failure of treatment provision, and four (6%) others. There were three syphilitic stillbirths who were prematurely born to untreated pregnant women and 67 live births (one set of twins) of which 27 met definitions of probable congenital syphilis. They received complete treatment with penicillin and had non‐reactive rapid plasma reagin within the first 6 months of life, with the exception of one who had non‐reactive rapid plasma reagin at the age of 7 months. Conclusions Congenital syphilis remains a problem in our setting. Nearly half of pregnant women who had syphilis had inadequate treatment. There is an urgent need to strengthen diagnosis and the treatment cascade of syphilis during antenatal care.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 94%

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Gaps in the elimination of congenital syphilis in a tertiary care center in Thailand

Anugulruengkitt

Yodkitudomying²,

Sirisabya

et al. 2020

Pediatrics International

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“…According to reports, in 2012, global neonatal syphilis infection accounted for 11.0% (102,000/930,000) [27]. It is worth noting that The treatment during pregnancy is directly related to congenital syphilis and patients with maternal syphilis who do not receive treatment or have inadequate treatment during pregnancy may increase the risk of congenital syphilis [31,32]. In our study, the untreated rate of maternal syphilis infection was significantly higher (74.5%) than other reports at home and abroad [5,33].…”

Section: Prevalence and Related Factors Of Pregnancy Syphilis Complicmentioning

confidence: 99%

Pregnancy syphilis epidemic trends, clinical features, APOs risk factors, pregnancy-induced hypertension epidemics and related factors, in Northeast China Jilin Maternity Hospital 2013-2017

Yang

Sun

et al. 2019

Preprint

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Background. It is of great public health significance to monitor the global meiosis mother-to-child transmission plan proposed by WHO and monitor the prevalence of maternal syphilis and the factors affecting mother-to-child transmission. Methods. We collected 271 medical records of prenatally diagnosed (from 87286 pregnant women) of syphilis among pregnant women a maternity hospital in Jilin Province China from 2013 to 2017. The chi-square test and Logistic multiple regression analysis were used to describe the clinical characteristics of pregnant women with syphilis and the related factors of adverse pregnancy outcome. Results. The average prevalence of maternal syphilis is 0.31% (95%[CI]: 0.27%-0.35%). The mean age of 271 pregnant women with syphilis is 27.62±5.4 years old. The maternal syphilis prevalence of absence of paid occupation is 73.8%; rural population accounts for 43.6%. Maternal women with a history of abortion accounted for 43.1%, of which 53.1% had abortion ≥2; The average rate of treatment in pregnancy is 25.5% (95%[CI]: 25.4%-25.6%). The prevalence rate of APOs are 43.9% (95%[CI]: 38.1%-49.9%), declined in five years (P<0.05). APOs was significantly higher in women at 30–34 age group than that in 0-24 age group (OR= 2.916, 95%CI: 1.298-6.549) and higher in Un-treatment in pregnancy than that in receive treatment (OR=2.469, 95%CI:1.225-4.975). PROM occurrence (OR=2.702, 95%CI:1.219-5.988); CRP elevation (≥10 mg/L) and RPR high titer (≥1:8) are related to the occurrence of APOs. Abortion, prematurity and low birth weight are associated with no treatment during pregnancy (P<0.05). Comparison of 42 cases of pregnancy-induced hypertension and non-pregnancy-induced hypertension, Dysmenorrhea (OR= 3.654, 95%CI:1.812-7.369) and elevated urine protein (OR= 2.259, 95%CI:1.161-4.394) are the influencing factors of maternal syphilis complicated with pregnancy-induced hypertension. Conclusions. The prevalence of maternal syphilis in northern China is lower than that of 10 years ago, but the decline is still lower than that in the economically developed regions of the south. The rate of non-treatment of syphilis during pregnancy is high, and should be alert to the rebound of maternal syphilis.

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“…[2][3][4] Among pregnant women with syphilis, the proportion with early syphilis has increased (35% in 2012 to 58% in 2016). 5 Identifying and adequately treating maternal syphilis at least 30 days before delivery prevents up to 98% of CS cases, 6,7 and thus the rising rate of CS signals shortcomings in current CS prevention.…”

mentioning

confidence: 99%