We describe the maternal characteristics and pregnancy outcomes of seropositive gravidas who delivered an infant with and without congenital syphilis.METHODS:
This is a retrospective chart review of gravidas diagnosed with syphilis at our county hospital system from January 2011 to December 2016. Maternal stage of syphilis was diagnosed according to CDC guidelines and the diagnosis of congenital syphilis was assigned by the managing clinician in the prenatal period and at delivery respectively. Maternal characteristics, stage of syphilis, treatment history, delivery and infant outcomes were recorded. Characteristics of patients who delivered a child that required treatment for congenital syphilis were compared to those who did not. Standard statistical analysis was performed.RESULTS:
94 gravidas were diagnosed with syphilis and 17 (18%) delivered an infant who required treatment for congenital syphilis. Most women had latent syphilis (n=15, 88%) and 2(11.8%) were diagnosed with serofast syphilis. Eight (47%) did not receive antenatal treatment. For those that did, gestational age at treatment was 26.4 + 11.4 weeks. Women with infants diagnosed with congenital syphilis were more likely to have no prenatal care, be diagnosed and treated later in pregnancy, have less time from treatment to delivery and receive treatment less than 4 weeks prior to delivery (p<0.01). Age, race, prevalence of co-morbidities, gestational age at delivery, and rate of prematurity were similar between the two groups.CONCLUSION:
Consistent with prior research, poor prenatal care and delayed antenatal treatment confers a higher risk of congenital syphilis. In the prevention of congenital syphilis, time is of essence.