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The Mortality of Congenital Syphilis.
Wozniak, Phillip S; Cantey, Joseph B; Zeray, Fiker; Leos, Nora K; Michelow, Ian C; Sheffield, Jeanne S; Wendel, George D; Sánchez, Pablo J.
Afiliação
  • Wozniak PS; University of Missouri Kansas City, Kansas City, MO; Children's Mercy Hospital, Kansas City, MO; University of Texas Southwestern Medical Center, Dallas, TX; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
  • Cantey JB; University of Texas Southwestern Medical Center, Dallas, TX; University of Texas Health Science Center at San Antonio, San Antonio, TX.
  • Zeray F; University of Texas Southwestern Medical Center, Dallas, TX.
  • Leos NK; University of Texas Southwestern Medical Center, Dallas, TX.
  • Michelow IC; Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, CT.
  • Sheffield JS; University of Texas Southwestern Medical Center, Dallas, TX; Johns Hopkins University School of Medicine, Baltimore, MD.
  • Wendel GD; University of Texas Southwestern Medical Center, Dallas, TX.
  • Sánchez PJ; University of Texas Southwestern Medical Center, Dallas, TX; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH. Electronic address: Pablo.Sanchez@NationwideChildrens.org.
J Pediatr ; 263: 113650, 2023 Dec.
Article em En | MEDLINE | ID: mdl-37536483
OBJECTIVES: To document the case-fatality rate (CFR) of congenital syphilis diagnosed by molecular tools and rabbit infectivity testing (RIT) of clinical specimens in addition to standard evaluation and to compare that with the CFR using the Centers for Disease Control and Prevention (CDC) surveillance case definition. STUDY DESIGN: Prospective, single site, cohort study of all cases of syphilis among mothers and their infants from 1984 to 2002. The diagnosis of congenital syphilis was determined using IgM immunoblotting, polymerase chain reaction, and RIT of fetal or infant specimens in addition to clinical, laboratory, and radiographic criteria. Data were retrospectively reviewed to ascertain fetal and neonatal mortality. RESULTS: During the 18-year study, there were 191 cases of congenital syphilis confirmed by abnormalities on clinical, laboratory, or radiographic evaluation and/or positive serum IgM immunoblot, blood polymerase chain reaction, or blood/cerebrospinal fluid RIT. Of the 191 cases, 59 died for a CFR of 31%. Of the 59 deaths, 53 (90%) were stillborn and 6 (10%) died in the neonatal period. The majority (74%, 39/53) of stillbirths occurred in the third trimester. The CDC surveillance case definition correctly identified all infants with congenital syphilis, but the CDC CFR was 10% which underestimated the CFR by more than 300%. CONCLUSIONS: Our findings corroborate the high sensitivity of the CDC surveillance definition for congenital syphilis but highlight its poor estimation of its associated mortality. The CFR among infected progeny of pregnant women with syphilis was 31%, due mostly to demise in the third trimester and as such highlights the need for detection and appropriate treatment of syphilis during pregnancy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Infecciosas na Gravidez / Sífilis Congênita / Sífilis Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Animals / Female / Humans / Infant / Pregnancy Idioma: En Revista: J Pediatr Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Infecciosas na Gravidez / Sífilis Congênita / Sífilis Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Animals / Female / Humans / Infant / Pregnancy Idioma: En Revista: J Pediatr Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos