The United States is seeing an alarming upward trend in babies born with congenital syphilis, with cases in one state seeing as high as a 1,000 percent spike.
Newborns with congenital syphilis were more likely to be born prematurely at less than 37 weeks and from mothers who used illicit drugs. They also had lower birth weights of around 3 pounds compared to babies without CS. The days the infants spent in the hospital were significantly longer, and the cost of their treatment was over four times as much.
Other findings showed that an estimated 97 percent were considered newborns (under 28 days old), over 71 percent were African American, and nearly 60 percent were born to mothers living in nonurban counties. The cohort was half male and half female; most were diagnosed with CS upon delivery.
Although most infants with CS were black, the percentage increase in cases was larger among white infants, with a jump of approximately 2,600 percent compared to just over 1,000 percent.
Over 91 percent of the infected babies were covered by Medicaid insurance compared to non-Medicaid coverage, making it the strongest predictor of the disease.
The retrospective study was collaborative between the Mississippi State Department of Health and the Mississippi Hospital Association.
The escalating trend is troubling for state health officials.
“Our investigation shows that the rapid rise of CS hospitalizations in Mississippi is a serious public health concern because of its grave social and health-related consequences,” the authors wrote in the paper.
What Is Congenital Syphilis?
According to the CDC, congenital syphilis is a disease caused by infection with Treponema pallidum bacteria that is passed neonatally from a pregnant mother to her baby. The health implications can be both short- and long-term. Infected babies can be affected by serious health consequences, including:- Deformities like saddle nose, protruding forehead and heavy brow (bossing), bowed tibia, joint swelling, abnormal tooth development, interstitial keratitis, neurologic deafness, and optic atrophy.
- Hepatosplenomegaly, the swelling and enlargement of the liver and spleen.
- Anemia.
- Jaundice.
- Failure to thrive.
National Rates of Congenital Syphilis
The rate of congenital syphilis has increased significantly in recent years. In 2019, 1,870 cases of CS were reported nationwide. Ninety-four were stillborn, and 34 diagnoses resulted in infant death.Detection and Treatment Strategies
Effective prevention and detection strategies to identify syphilis in pregnant women are critical to reversing the rising trend of congenital syphilis. The U.S. Preventive Service Task Force recommends all pregnant women get tested for syphilis as early as possible when they find out they are pregnant. If the woman has not had prenatal care, she should be tested at delivery. According to the task force, most pregnant women do have prenatal care; however, they are not screened or treated for syphilis early enough to prevent transmission to the baby.- Women living in regions where there is a high infection rate of the disease.
- Women with HIV.
- Women with a history of being incarcerated or working in the sex industry.
- Women who have been with a known infected partner.
- Women who had no previous prenatal care or were late in getting it (a first visit during the second trimester or later).
- Women with a history of illicit drug use, especially methamphetamine or heroin.
- Women who are homeless or living in an unstable household.
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