644 - Six-fold increase in the incidence of Congenital Syphilis in U.S Neonatal ICUs

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 644
Publication Number: 644.226

Tala R. Nasr Brack, Baylor University Medical Center, Dallas, TX, United States; Veeral Tolia, Baylor University Medical Center, Dallas, TX, United States; Monica M. Bennett, Baylor Scott & White Research Institute, Dallas, TX, United States

Presenting Author(s)

TN

Tala R. Nasr Brack, MD (she/her/hers)

Neonatologist
Baylor University Medical Center/ Pediatrix
Dallas, Texas, United States

Background: Congenital syphilis (CS) presents a significant public health problem. Since 2012, there has been a dramatic increase in reported cases of congenital syphilis. However, recent trends in NICU utilization of infants with CS have not been well described.

Objective: We sought to evaluate recent data on the incidence of CS, as well as demographic characteristics, hospital treatment and outcomes of infants with CS in the NICU.

Design/Methods: We performed a retrospective review of all infants in the Pediatrix Clinical Data Warehouse (CDW) from 2011-2020. Prevalence of CS was calculated as number of infants diagnosed with CS admitted to the NICU, divided by the total number of NICU infants. We evaluated trends in incidence and health care utilization as well as changes in infant and maternal characteristics in five consecutive two year periods.

Results:

We included 842,928 infants discharged over the study period. Between 2011 and 2020 the prevalence of CS increased from 0.8 to 4.6 per 1000 infants (P< 0.05). Mortality (~1% of all infants with CS) and many of the clinical characteristics remained stable over the decade.

Maternal co-infection with Hepatitis C increased from 2.3% to 5.2% and maternal drug use of infants born with CS increased from 6.1% to 24.6% between 2011-2012 and 2019-2020. Most infants were treated with PCN for 10 days and median length of stay was 10 days.

Conclusion(s): From 2011-2020 the prevalence of Congenital Syphilis in the Pediatrix CDW increased almost 6-fold. The majority of these patients were 36-37 weeks. As these are infants who otherwise may have not needed intensive care, this rise in prevalence has likely contributed to a substantial increase in NICU utilization.