Maternal and congenital syphilis in Brooklyn, NY. Epidemiology, transmission, and diagnosis
S. A. Rawstron, S. Jenkins, S. Blanchard, P. W. Li and K. Bromberg
Children's Medical Center of Brooklyn, Department of Pediatrics, NY 11203.
OBJECTIVE--To define the epidemiology, to determine factors associated with
transmission, and to describe the clinical and laboratory features of
congenital syphilis. DESIGN--Retrospective chart review and prospective
analysis. SETTING--Kings County Hospital Center, Brooklyn, NY. PATIENTS--A
total of 403 pregnancies during a 23-month period associated with positive
syphilis serological findings. RESULTS--Seventy-three pregnancies (18%)
resulted in congenital syphilis (35 live-born and 40 stillborn neonates).
Pregnancies associated with congenital syphilis were significantly
associated with lack of prenatal care, lack of maternal therapy for
syphilis, and a higher rapid plasma reagin titer, but not with a reported
history of "crack" or cocaine use, although detection of cocaine in urine
samples was more likely with positive syphilis serology. CONCLUSION--Most
live-born infants with congenital syphilis (23 of 35) lacked rash,
hepatosplenomegaly, or adenopathy but were identified by laboratory tests
(roentgenograms, cerebrospinal fluid VDRL test, conjugated bilirubin
determination, or aspartate aminotransferase levels in serum samples). Half
of the infants with congenital syphilis were stillborn.
