An epidemic of congenital syphilis in Jefferson County, Texas, 1994-1995. Inadequate prenatal syphilis testing after an outbreak in adults

Objectives. After a syphilis epidemic in Jefferson County, Texas, in 1993 a nd 1994, congenital syphilis prevalence and risk factors were determined an d local prenatal syphilis screening practices were assessed. Methods. Medical records were reviewed, pregnant women with syphilis were i nterviewed, and prenatal care providers were surveyed. Results. Of 91 women, 59 (65%) had infants with congenital syphilis. Among African Americans, the prevalence per 1000 live births was 24.1 in 1994 and 17.9 in 1995. Of the 50 women with at least 2 prenatal care visits who had infants with congenital syphilis, 15 (30%) had received inadequate testing . Only 16% of 31 providers obtained an early third-trimester syphilis test on all patients. Conclusions. Inadequate prenatal testing contributed to this outbreak of co ngenital syphilis.