Characteristics of Mothers of Infants Born With Congenital Syphilis at a Tertiary Care Hospital in Fresno, United States.

objectiveCongenital syphilis (CS) continues to be a prevalent but preventable cause of infant morbidity and mortality. This study investigates the characteristics of women who delivered infants diagnosed with CS.

methodsRetrospective data were collected from electronic medical records of 231 mother-newborn dyads diagnosed with CS at delivery in Community Regional Medical Center, a tertiary care hospital in Fresno, California, USA, between January 2010 and December 2018. T-tests and Fisher's exact tests compared maternal and neonatal characteristics by syphilis treatment and prenatal care status. Log-linear models estimated relative risks (RRs) and 95% confidence intervals (CIs) for predictors of no prenatal care and no or inadequate treatment. All statistical tests were two-sided with an alpha level of 0.05.

resultsTwenty-one percent of women did not receive prenatal care, 51.5% received inadequate treatment, and 15% received no treatment for syphilis during pregnancy. No or insufficient syphilis treatment was more common among unemployed women, those who used drugs, smoked, had Medicaid, had no prenatal care, were incarcerated, or had abnormal neonatal outcomes. Drug use during pregnancy was associated with a 1.26-fold increased risk of receiving no or inadequate treatment (RR: 1.26, CI: 1.03-1.54) and a 3.32-fold increased risk (RR: 3.32, CI: 1.64-6.71) of having no prenatal care compared to women who did not use drugs.

conclusionWomen from minority groups who were unmarried, unemployed, homeless, or using illicit drugs were more likely to receive inadequate prenatal care and no treatment for syphilis during pregnancy. Strengthening public health infrastructure to test and provide care for these high-risk pregnant women is urgently required.