Congenital syphilis rates soared in US newborns from 2012 to 2022
Laine Bergeson12 minutes ago.
Sexually Transmitted Infections
Congenital syphilis rates among US newborns increased nearly sixfold from 2012 to 2022, according to a study published yesterday in Clinical Infectious Diseases. The data show rising rates across all demographics and income levels, with the sharpest increases among Native Americans.
Congenital syphilis occurs when a pregnant woman with untreated syphilis passes the infection to her baby. The infection can cause organ damage, skeletal abnormalities, neurodevelopmental impairment, stillbirth, and infant death.
For the study, researchers from Johns Hopkins University analyzed hospital records representing 14.6 million birth hospitalizations in 2012, 2016, 2019, and 2022, including an estimated 6,560 newborns diagnosed as having congenital syphilis.
22-fold increase in Native American babies
The team found that congenital syphilis rates increased from 16.0 per 100,000 birth hospitalizations in 2012 to 94.7 per 100,000 in 2022, a 5.9-fold increase. The estimated number of affected newborns rose from 597 to 3,325 over that period.Rates increased across all racial and ethnic groups, income levels, and hospital settings, with the largest increase occurring among American Indian and Alaska Native newborns. Among this population, rates rose from 22.7 per 100,000 birth hospitalizations in 2012 to 486.0 per 100,000 in 2022, a 21.5-fold increase, although the confidence intervals for these statistics were wide, indicating imprecision.
In 2022, Hispanic newborns accounted for the largest number of congenital syphilis hospitalizations (1,010), followed by Black newborns (970) and White newborns (785). By income level, congenital syphilis rates were highest among newborns from the lowest-income ZIP codes (186.8 per 100,000 birth hospitalizations) and among those covered by public insurance (177.4 per 100 000).
Geographically, in 2022, the West had the highest rates, at 126.0 per 100,000 birth hospitalizations, although over half of the birth hospitalizations (1,682) that year occurred in the South.
Federal cuts to family planning may fuel rising rates
Congenital syphilis is largely preventable through prenatal screening and timely treatment. The researchers point to several factors that may be fueling its rise, including limited access to prenatal care, especially in rural areas, and federal funding cuts to family-planning programs. Ongoing shortages of benzathine penicillin G (Bicillin L-A), the only recommended treatment for syphilis during pregnancy, may also complicate efforts to curb rising rates.Because the study included only in-hospital births and not stillbirths or other fetal losses related to congenital syphilis, the findings likely underestimate disease burden, note the researchers. This underestimation might be especially true among Native Americans, because federal facilities such as Indian Health Service hospitals, which account for approximately 10% of American Indian and Alaska Native births, were not included in the study.
“It is critically important to reverse the rise in [congenital syphilis],” write the researchers, who call for expanded prenatal screening, improved access to timely treatment, and a reliable medication supply.
