J Korean Soc Matern Child Health.  2021 Jul;25(3):204-210. 10.21896/jksmch.2021.25.3.204.

Congenital Syphilis in Neonate: A Single Center Study for 10 Years

• Lee N
• Jeong MH
• Jeong SH
• Bae MH
• Han YM
• Park KH
• Byun SY

• KMID: 2518924
• DOI: http://doi.org/10.21896/jksmch.2021.25.3.204

Abstract

Purpose
Syphilis infections are becoming more prevalent in the Republic of Korea, and inadequately treated syphilis can lead to congenital syphilis (CS) in newborns. This study aimed to analyze the clinical manifestations of syphilis in mothers and newborns and to make suggestions to improve disease prognosis.
Methods
This single-center study was performed between August 2009 and August 2019 and included 29 newborns with CS. We retrospectively evaluated the clinical features, rapid plasma reagin (RPR) card test, fluorescent treponemal antibody absorption test (FTA-ABS), morbidity, and treatment regimen of all the syphilis-affected mothers and their newborns.
Results
At the time of delivery, mean maternal age was 29.0±6.1 years old, and newborn gestational age was 38.0 weeks. In cases when syphilis was confirmed during the second and third trimesters of pregnancy, the newborn with CS had morbidity (p=0.004). The mean RPR titer was related to morbidity (p= 0.036). Positive results of FTA-ABS IgM (p<0.001) and pleocytosis in the cerebrospinal fluid (CSF) (p= 0.020) also increase morbidity. The most common symptoms were desquamation and skin rash, followed by hepatomegaly, neurodevelopmental disability, and bone abnormalities. The highest number of CS cases per 1,000 live births in this hospital was in 2014.
Conclusion
CS is a preventable and treatable disease if physicians detect symptoms and provide appropriate treatment through RPR examinations during every trimester. General practitioners should be widely trained on various aspects including early detection, formal treatment, and regular follow-up. Additionally, medical services should be provided for the entire childbearing population regardless of the socioeconomic status.

Keyword

Congenital syphilis, Screening, Outcome

Figure

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  Fig. 1. Incidence of syphilis in Republic of Korea (ROK) and congenital syphilis (CS) cases per 1,000 neonatal intensive care unit admissions in Pusan National University Hospital (PNUH).

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