EPIDEMIC SYPHILIS - MATERNAL FACTORS ASSOCIATED WITH CONGENITAL INFECTION

Citation
Bl. Mcfarlin et al., EPIDEMIC SYPHILIS - MATERNAL FACTORS ASSOCIATED WITH CONGENITAL INFECTION, American journal of obstetrics and gynecology, 170(2), 1994, pp. 535-540
Citations number
33
Categorie Soggetti
Obsetric & Gynecology
ISSN journal
00029378
Volume
170
Issue
2
Year of publication
1994
Pages
535 - 540
Database
ISI
SICI code
0002-9378(1994)170:2<535:ES-MFA>2.0.ZU;2-I
Abstract
OBJECTIVE: Little is known about which cases of maternal syphilis will affect the newborn. Because of the current epidemic of syphilis in pr egnancy in our city, we sought to identify risk factors during pregnan cy associated with congenital infection. STUDY DESIGN: We reviewed 253 cases of maternal syphilis prospectively identified over a 1-year per iod. On the basis of neonatal diagnosis, these data were divided into two groups, those without evidence of presumptive congenital syphilis and those with evidence of presumptive congenital syphilis. Presumptiv e congenital syphilis was defined according to the Centers for Disease Control and Prevention surveillance case definition. Cases with blood y spinal taps and cases of suspected congenital syphilis that did not meet these criteria were excluded. Venereal Disease Research Laborator y titers are given as the inverse of the geometric mean. RESULTS: Vene real Disease Research Laboratory titer at time of diagnosis and unknow n duration of disease were risk factors for congenital syphilis. There was a significantly decreased rate of congenital syphilis with single -dose therapy if disease length was < 1 year (p < 0.005). Unknown dura tion of disease was associated with 67.9% and 48.6% Fates of congenita l syphilis with one- and three-dose therapy respectively. There was a 28% incidence of preterm birth. CONCLUSION: Our study suggests an alar ming rate of failure of current therapy to prevent congenital syphilis . Venereal Disease Research Laboratory titer at time of diagnosis and unknown duration of disease are risk factors for congenital syphilis. The high rate of presumptive congenital syphilis in the unknown durati on group indicates that identification before or earlier in pregnancy wilt be necessary to prevent devastating consequences for the neonate.