TP 6 Ten-Year Epidemiologic Review of Congenital Syphilis, New York State, Excluding New York City, 2003-2012

Tuesday, June 10, 2014
Pre-function Lobby (M2)
Lusine Ghazaryan, MD, MPH1, Alison Muse, MPH1, Suzanne Beck, BS1, Lou Smith, MD, MPH2 and Alicia Lee, MPH3, 1Bureau of STD Prevention and Epidemiology, New York State Department of Health, Albany, NY, 2Division of Epidemiology, Evaluation and Research, New York State Department of Health, Albany, NY, 3Bureau of STD Prevention and Epidemiology, Albany, NY

Background:  Elimination of congenital syphilis (CS) is a top national and New York State (NYS) priority. The study describes epidemiologic characteristics of CS cases which have been reported in NYS, excluding New York City (NYC) during the last decade.  It also examines association of maternal prenatal care with syphilitic stillbirth for CS cases reported during 2003-2012.

Methods:  A retrospective review of surveillance information was conducted.  STD case report data are collected and maintained in Communicable Disease Electronic Surveillance System (CDESS). For cases with incomplete electronic surveillance information, data were extracted from CS case investigation and report forms.  

Results:  During 2003-2012, a total of 86 CS cases were reported to CDESS. Of these, 12 CS cases (14.0%) were adopted and were excluded from subsequent analysis due to lack of information on biologic mothers. The majority of CS cases were born to black non-Hispanic (29, 39.7%) or Hispanic (25, 34.2%) mothers and ranged 0-28 years old at diagnosis.  While all administrative regions reported CS cases, the majority (56, 75.7%) of CS cases were reported in the three counties surrounding NYC. With exception of a set of twins, all other term deliveries resulted in singletons. Six (8.1%) CS cases were reported with classic signs of CS on physical examination. Five of the cases (6.8%) were syphilitic stillbirths and 1 (1.4%) newborn was born alive and subsequently died.  Among these 6 cases, half of women did not have prenatal care compared to 10.5% of mothers who delivered at term. Overall, 10 (13.7%) mothers did not have any prenatal care. 

Conclusions:  Additional studies are needed to establish specific barriers to seeking timely and adequate prenatal care among women who deliver CS cases. In jurisdictions with high burden of CS, strategies to scale up antenatal screening programs to prevent adverse perinatal outcomes need to be considered.