ABSTRACT
BACKGROUND: There are minimal neurodevelopmental follow-up data for infants exposed to syphilis in utero. METHODS: This is an inception cohort study of infants exposed to syphilis in utero. We reviewed women with reactive syphilis serology in pregnancy or at delivery in Edmonton (Canada), 2002 through 2010 and describe the neurodevelopmental outcomes of children with and without congenital syphilis. RESULTS: There were 39 births to women with reactive syphilis serology, 9 of whom had late latent syphilis (n = 4), stillbirths (n = 2) or early neonatal deaths (n = 3), leaving 30 survivors of which 11 with and 7 without congenital syphilis had neurodevelopmental assessment. Those with congenital syphilis were all born to women with inadequate syphilis treatment before delivery. Neurodevelopmental impairment was documented in 3 of 11 (27%) infants with congenital syphilis and one of 7 (14%) without congenital syphilis with speech language delays in 4 of 11 (36%) with congenital syphilis and 3 of 7 (42%) without congenital syphilis. CONCLUSIONS: Infants born to mothers with reactive syphilis serology during pregnancy are at high risk for neurodevelopmental impairment, whether or not they have congenital syphilis, so should all be offered neurodevelopmental assessments and early referral for services as required.
Subject(s)
Neurodevelopmental Disorders/etiology , Pregnancy Complications, Infectious/microbiology , Syphilis, Congenital/complications , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Canada , Cohort Studies , Female , Humans , Infant, Newborn , Mothers , Neurodevelopmental Disorders/microbiology , Outcome and Process Assessment, Health Care , Parturition , Pregnancy , Risk Factors , Syphilis Serodiagnosis , Syphilis, Congenital/drug therapy , Syphilis, Congenital/mortality , Treponema pallidum , Young AdultABSTRACT
BACKGROUND: Few data exist on the serologic outcome of treponemal tests in congenital syphilis. METHODS: A chart review was conducted on all confirmed early congenital syphilis cases in Edmonton, Canada, from 2005-2010. RESULTS: Of the 16 cases identified, 11 (69%) infants seroreverted their treponemal tests by 18 months. Cases that did not serorevert their treponemal tests were statistically more likely to have delayed treatment and to have higher maternal rapid plasma reagin titers at birth. CONCLUSIONS: Our data suggest that the majority of early congenital syphilis cases will serorevert their treponemal tests by 18 months.