Congenital Syphilis Rates Correlate With Increased Maternal Syphilis Rates in a New Orleans Tertiary Care Center [30I

Abstract

INTRODUCTION: In recent years, the number of congenital syphilis (CS) cases in the United States increased from 8.4 to 11.6 cases per 100,000 live births. In 2017, Louisiana reported the highest rates of CS in the country. This study aims to determine provider management patterns for newborns at risk for CS. METHODS: All cases of maternal syphilis from 2013-2017 at Touro Infirmary in New Orleans, LA were identified using ICD-9 and ICD-10 codes. Women who were serofast were excluded. Seventy-three mother child pairs were identified with available records. Charts were reviewed for stage of syphilis, treatment regimen during pregnancy, interval from treatment to delivery and other variables. Newborn information including neonatal intensive care unit (NICU) admission, physical and radiologic exam findings, nontreponemal titers, treatment regimen and other outcomes were recorded. Variables were summarized using means with standard deviations and frequencies expressed as percentages. RESULTS: Of the 73 newborn charts reviewed, 8.96% (n=6) were found to be symptomatic, however only 83.3% of them were admitted to the NICU. Only 29.6% of infants were adequately treated with an extended penicillin regimen if the mother did not receive appropriate treatment. Furthermore, only 63.0% of newborns had a nontreponemal titer performed. Only twenty six percent (n=16) of asymptomatic newborns (n=61) considered low risk for CS received single dose penicillin. CONCLUSION: With the rising rates of both maternal and CS, strict adherence to the CDC guidelines for treatment of CS must be maintained. Attention to maternal treatment guidelines and vigilant follow up are necessary to ensure treatment success.