SECULAR TRENDS IN NEW-YORK-CITY-HOSPITAL DISCHARGE DIAGNOSES OF CONGENITAL-SYPHILIS AND COCAINE DEPENDENCE, 1982-88

The ecologic relationship between the incidence of reactive serologic tests for syphilis among 2,229 newborns and diagnoses that included co caine dependence among 17,219 hospitalized women ages 15-44 in New Yor k City was investigated. City-wide, race-specific and zip code-specifi c annual rates were computed. The residential zip codes were grouped i nto quartiles by cumulative level of diagnoses that included cocaine d ependence, and city-wide and race-specific annual rates of congenital syphilis were computed in each quartile. From 1982 to 1988, the citywi de rate of congenital syphilis for all races increased from 1.2 to 5.8 per 1,000 live births, while rates of cocaine dependence discharges i ncreased from 23.3 to 423.3 per 100,000 women of all races during the same period. For African American infants, citywide rates of congenita l syphilis increased from 1.8 to 10.6 per 1,000 live births. In quarti le-specific analyses of African American women and newborns, rates of congenital syphilis increased from 1.9 to 14.6 in the highest cocaine- exposure quartile, from 2.1 to 12.4 in the third, from 1.5 to 7.6 in t he second; and, from 1.6 to 2.8 in the lowest cocaine-exposure quartil e. This study provides support for the hypothesis that cocaine depende nce in women may be associated with congenital syphilis infection.