The number of newborns hospitalized for syphilis in Mississippi has increased by more than 1,000% in just six years, a study finds.
Babies born with congenital syphilis (CS), transmitted from mother to fetus, increased from 10 cases in 2016 to 110 in 2022.
The raw numbers appear low, but the Centers for Disease Control and Prevention as well as state health officials are concerned about how quickly BC diagnoses are increasing.
This disease increases the risk of bone damage, anemia, jaundice, nerve damage and meningitis. It can be treated with antibiotics, but it kills about 40 percent of babies born with it.
Maternal drug use is driving the increase, as the rate of mothers using drugs during pregnancy is the highest since 2017. Mississippi also lacks insufficient pre-pregnancy screening that could prevent serious unnecessary illness and death.
Nearly a quarter of babies with congenital syphilis are born to mothers with a substance abuse problem. Nearly 70 percent of these mothers used cannabis, while about 27 percent used cocaine.
From 2016 to 2022, CS hospitalization rates in Mississippi increased more than 10-fold.
As rates of babies born with CS in Mississippi have increased in recent years, so have cases of babies born too early and too small, which are leading causes of infant death in the state.
About a quarter of babies with CS in Mississippi were born to mothers with a substance use disorder, and most of the mothers were enrolled in Medicaid, the federal health insurance program for Americans poor.
As rates of babies born with CS in Mississippi have increased in recent years, so have cases of babies born too early and too small, which are leading causes of infant death in the state.
Of the six CS-associated deaths during the study period, only three occurred in 2022.
Epidemiologists in Mississippi analyzed hospital discharge data from 2016 to 2022 to better understand the public health crisis that congenital syphilis has become in the state. During this period, hospitalizations for congenital syphilis increased tenfold.
The Mississippi-based researchers said, “Although the upward trend is consistent with national CS monitoring data, the recovery in Mississippi has been even steeper. This increase is concerning because decades of research have demonstrated the dire health consequences of CS, including prematurity, low birth weight, and death.
During this five-year period, 367 babies were hospitalized for CS. The vast majority of them were diagnosed with CS and hospitalized from birth.
In addition to the increasing number of infants hospitalized, the rate of hospitalization for CS has also increased, from two hospitalizations for CS per 10,000 total infant hospitalizations in 2016 to almost 25 for CS per 10,000 total in 2022 – a peak of 1,140 percent.
Nearly a quarter of babies with CS are born to mothers with a substance use problem, primarily involving cannabis, followed by cocaine, amphetamines and opioids.
The authors said: “Over the last three years of the study period, there was a gradual but steady increase in the proportion of newborns hospitalized for CS and exposed to illicit substances in utero: 17.7 % in 2020, 22.7% in 2021 and 23.8%. % in 2022.
“This finding reveals the entanglement between the ongoing drug epidemic and the resurgence of maternal and congenital syphilis and suggests the need for holistic approaches that treat illicit drug use as a means to reduce CS rates.”
Babies with CS were twice as likely to be born prematurely – before 37 weeks gestation – and four times more likely to be born dangerously underweight, or below five pounds, eight ounces.
Doctors also found that one in five babies born prematurely with CS suffered from respiratory distress, usually due to the lungs not having enough time to fully develop in the womb.
In addition to causing breathing problems, congenital syphilis can cause a baby to be born with a wide range of other serious problems, such as jaundice, the result of the buildup of a substance in the blood called bilirubin that causes baby’s skin and the white parts of it, their eyes appear yellow.
It can also cause swelling of the baby’s spleen and liver, this can contribute to anemia caused by a lack of healthy red blood cells to carry oxygen to the rest of the body, and eventually lead to meningitis which causes a swelling of the brain and spinal cord. .
Congenital syphilis occurs when a pregnant mother passes syphilis to her child
On average, newborns with CS weighed 349 g less (mean birth weight: 2788 g) than newborns without CS.
Among African American infants, hospitalizations for CS increased by 1,029%, from 7 infants in 2016 to 79 in 2022.
The nationwide spike in congenital syphilis reflects an increase in the number of men and women contracting the disease nationwide, less than two decades after many thought the disease was virtually eliminated.
The reasons for this increase are multiple, but key factors include: increased illicit drug use, distrust of the health care system, and a decline in federally funded sexual health programs, while that some public health officials blame dating apps for the increase. promote a culture of casual sex.
The problem is particularly serious in Mississippi, which until March 2023 was one of the few states that did not require syphilis screening for potential new mothers.
The authors said: “By contributing to under-screening, this policy omission has led to missed opportunities to detect and treat maternal syphilis before infants are born.
“Providing comprehensive prenatal care, effective screening and early treatment to pregnant Mississippi women is not only good public health policy in general, but also smart strategies to improve pregnancy outcomes, reduce disease and death children, reduce medical costs and promote greater health equity. .’
The report was published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.