Syphilitic Babies Highlight Prenatal Care Gap

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Syphilitic BabiesA new study by the Centers for Disease Control (CDC) highlights an increased rate of congenital syphilis (CS) in the U.S. CS happens when an infected mother passes the infection on to a child during pregnancy. Approximately 40% of babies with CS will experience stillbirth, miscarriage, and birth defects like blindness or deafness.

The rate of CS within the U.S. is still relatively low—only 458 babies were born with CS during 2014. But it is a reversal of what was previously a shrinking trend; from 2008 to 2012, the rates had been on the decline and shrunk from 446 to 334 per year. In two years, the number of CS cases not only reversed this decline but grew slightly past where it had started.

Congenital syphilis is highly preventable. If a pregnant woman with syphilis is given penicillin, there is a 98% chance she will not pass the disease on to her child. Due to this, CS rates are considered a “sentinel event” by the CDC. The term refers to incidents that represent multiple missed opportunities within the healthcare system. For CS, the opportunities are preventing the mother’s case of syphilis in the first place and the prenatal care that could have prevented the infant transmission.

The study notes that of the mothers with children born with CS, 21.8% received no prenatal care, 9.6% had no information about available prenatal care, 43% received no treatment for syphilis while pregnant, and 30% received inadequate treatment. The study did not assess the underlying reasons for these results. Possible explanations include the mothers fearing cost or stigma, being unaware that they qualified for prenatal care coverage under Medicaid or trouble diagnosing syphilis in the first place.

Reversing this spike, which is the highest in the country since 2001, will take a multifaceted approach. Improved STD screening, prenatal screening, patient education, and easing barriers to prenatal care needs to be tackled by health care providers and officials at both local and state level.

Syphilis can be difficult to diagnose because most people with the disease may not realize they have it. Barring the initial lesions and rash, it is possible for someone to be otherwise asymptomatic but still capable of infecting other sex partners or unborn children. If caught early, syphilis is highly treatable. All 458 cases of congenital syphilis covered by the CDC study are considered preventable.

Sources for Today’s Article:
Bowen, V., et al., “Increase in Incidence of Congenital Syphilis — United States, 2012–2014,” Morbidity and Mortality Weekly Report, 2015; 64(44); 1241-1245.

Chen, A., “More Babies Are Dying Because Of Congenital Syphilis,” NPR web site, November 12, 2015; http://www.npr.org/sections/health-shots/2015/11/12/455768422/more-babies-are-dying-because-of-congenital-syphilis.

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