Background: Risk factors for syphilis infection in pregnant women have been largely studied. Nevertheless, few studies have determined the risk factors for the vertical transmission comparing two groups of women with syphilis, those who had an infant with Congenital Syphilis (CS) and those whose infant was born healthy.
Objectives: The aim of this study was to assess the role of the third trimester test that is recommended for high prevalence sites and identify the risk factors for CS in Puerto Rico.
Methods: A case-control study was performed, analyzing data from years 2000 to 2007 of the STD Surveillance System in Puerto Rico. The sample comprises 118 cases and 118 controls.
Results: Multiple logistic regression analysis revealed those mothers who weren’t screened for syphilis early in the third trimester of pregnancy decreased their possibility of having an infant with CS by half when compared with those women who were screened; women who had three or more syphilis tests performed during pregnancy and those who received prenatal care (PNC) had significantly less possibility of having an infant with CS; and those mothers whose syphilis infection was on the phases primary, secondary and early latent showed significantly higher possibility of having an infant with CS.
Conclusions: PNC is a powerful tool for CS prevention and recommendations of performing a second screening during the third trimester should be followed in Puerto Rico.
Implications for Programs, Policy, and/or Research: 1. Screening for syphilis during pregnancy should be available inside and outside PNC setting, especially for high risk populations which are less likely to receive PNC, 2. Medical and PNC providers should incorporate specific questions in their patient’s medical history about previous syphilis infection and 3. All pregnant women who are sexual workers should be treated for syphilis as soon as they have contact with a medical provider.