THE RESURGENCE OF CONGENITAL-SYPHILIS - A COCAINE-RELATED PROBLEM

The relationship of maternal illicit drug use to congenital syphilis w as studied in a population of newborn infants (N = 1012) who were scre ened for intrauterine exposure to illicit drugs by meconium analysis a nd whose mothers were screened for syphilis by the rapid plasmin reagi n fluorescent treponemal antibody, absorbed (RPR/FTA-ABS) test. The re sult of the meconium drug screening was positive in 449 (44.3%) infant s: 401 (39.6%) screening results were positive for cocaine, 71 (7%) po sitive for opiate, and 31 (3.1%) positive for cannabinoid. The materna l RPR/FTA-ABS result was positive in 72 (7.1%) women, and congenital s yphilis was diagnosed in 46 (4.5%) infants on the basis of Centers for Disease Control and Prevention definitions. The incidence of positive RPR/FTA-ABS result (10.5% vs 4.4%) and congenital syphilis (7% vs 2.5 %) was significantly higher (p < 0.01) among infants with positive res ults compared with those with negative drug screening results. Similar ly, the incidence of positive RPR/FTA-ABS (11% vs 4.6%) and congenital syphilis (8% vs 2.3%) was significantly (p < .0.01) higher among infa nts with cocaine-positive results compared with those with cocaine-neg ative results. We conclude that maternal illicit drug use, specificall y cocaine, is significantly related to the resurgence of congenital sy philis among newborn infants.