Risk Factors Associated with Congenital Syphilis, Georgia, 2008-2015

• Type of Material: Article
• Authors: Alisa Kachikis, University of Washington; Melissa A. Schiff, University of New Mexico; Kathryn Moore, University of Michigan; theresa Chapple-McGruder, Oak Park Department of Public Health; Jessica Arluck, Emory University; jane Hitti, University of Washington
• Language: English
• Date: 2023-11-08
• Publisher: Wiley
• Publication Version: Final Published Version
• Copyright Statement: © 2023 Alisa Kachikis et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1155/2023/3958406
• Title of Journal or Parent Work: Infectious Diseases in Obstetrics and Gynecology
• Volume: 2023
• Issue: 1
• Start Page: 3958406
• Grant/Funding Information: This work was supported by the National Institute of Allergy and Infectious Diseases (grant number K23AI153390-01A1).
• Keywords: Georgia Department of Public Health; Congenital syphilis; women with syphilis infection
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Obstetrics and Gynecology; Health Sciences, Public Health

Abstract

Background Congenital syphilis (CS) is associated with significant perinatal morbidity and mortality. The study objectives were to compare risk factors among women with syphilis infection whose pregnancies did and did not result in CS cases and to evaluate other geographic and socioeconomic characteristics of county of residence as a measure of healthcare inequity. Methods This study linked maternal and congenital syphilis data from the Georgia Department of Public Health (DPH), 2008-2015. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline was followed. Demographic, behavioral, and case characteristics were compared among women with syphilis infection who did and did not have an infant with CS. Chi-square, Fisher's exact, and multivariate regression analyses were performed using STATA 14.2 (College Station, TX). Results Of 505 women with syphilis infection, 23% had an infant with CS, while 77% did not. After adjusting for race/ethnicity, factors associated with CS outcome were age greater than 35 years (adjusted odds ratio (aOR) 3.88; 95% confidence interval (CI) 1.01-14.89), hospital/emergency department diagnosis of syphilis (aOR 3.43; 95% CI 1.54-7.62), and high-risk behaviors such as exchanging sex for money or drugs (aOR 3.25; 95% CI 1.18-8.98). There were no associations between characteristics of county of residence and CS outcome. Conclusions This study highlights risk factors that may be associated with CS incidence and the adverse pregnancy outcomes associated with CS. Further work is needed to study improved data collection systems, contributing factors related to CS as well as prevention measures in the United States.