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The number of newborn babies hospitalized with syphilis in Mississippi increased by more than 1,000 percent in just six years, according to a study.
Babies born with congenital syphilis (CS), which is transmitted from mother to fetus, increased from 10 cases in 2016 to 110 in 2022.
The raw numbers seem low, but the Centers for Disease Control and Prevention, as well as state health officials, are concerned about the rapid pace at which CS diagnoses are increasing.
The condition increases the baby’s 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 has insufficient pre-pregnancy screenings that could prevent unnecessary illness and death.
Nearly a quarter of babies with congenital syphilis were born to mothers with substance use problems. Nearly 70 percent of those 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 the 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 mothers were enrolled in Medicaid, the federal health insurance program that serves poor Americans.
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 the leading causes of infant death in the state.
Of the six deaths associated with CS 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 that time, hospitalizations for congenital syphilis multiplied by 10.
The Mississippi-based researchers said, “Although the upward trend was consistent with nationwide surveillance data for CS, the rebound in Mississippi was even more pronounced.” This increase is concerning because decades of research have demonstrated the dire health consequences of CS, including prematurity, low birth weight, and death.
During that five-year span, 367 babies were hospitalized with CS. The vast majority of them were diagnosed with CS and hospitalized right when they were born.
In addition to the large number of hospitalized infants on the rise, the rate of CS hospitalization has also increased, from two CS hospital admissions per 10,000 total infant hospital admissions in 2016 to almost 25 per CS out of a total of 10,000 in 2022. an increase of 1,140 percent.
Nearly a quarter of babies with CS were born to mothers with some type of substance use problem, primarily cannabis, followed by cocaine, amphetamines and opioids.
The authors said: ‘During the last 3 years of the study period, there was a gradual but steady increase in the proportion of newborns hospitalized with 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 intertwining between the current drug epidemic and the resurgence of maternal and congenital syphilis and suggests the need for holistic approaches that treat illicit drug use as a way to reduce CS rates.”
Babies with CS were twice as likely to be born prematurely (before 37 weeks of gestation) and four times as likely to be born dangerously underweight, or less than five pounds, eight ounces.
Doctors also found that one in five babies born prematurely and with CS were diagnosed with respiratory distress, usually as a result of the lungs not having enough time to fully develop in the womb.
In addition to causing breathing problems, congenital syphilis can cause the baby to be born with a wide range of other serious problems, such as jaundice, a result of the buildup of a substance in the blood called bilirubin, which causes the baby’s skin and tissue. they deteriorate. the whites of his eyes looked yellow.
It can also cause the baby’s spleen and liver to swell, may contribute to anemia caused by a deficit of healthy red blood cells to carry oxygen to the rest of the body, and possibly lead to meningitis that causes inflammation 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 2,788 g) than newborns without CS.
Among African American infants, hospitalizations for CS increased by 1,029 percent, rising from 7 infants in 2016 to 79 in 2022.
The nationwide rise in congenital syphilis reflects the increase in men and women contracting the disease nationwide, less than two decades after many thought the disease was virtually eliminated.
The reasons for the increase are multifaceted, but some of the main drivers include: the increase in illicit drug use, distrust in the health care system and the decline of federally funded sexual health programs, while some health care officials Public health officials blame dating apps for driving a culture of casual sex.
The problem is particularly acute in Mississippi, which until March 2023 was one of the few states that does not require syphilis testing for expectant mothers.
The authors said: “By contributing to under-detection, this policy omission led to missed opportunities to detect and treat maternal syphilis before babies are born.”
‘Providing comprehensive prenatal care, effective screening and early treatment for pregnant women in Mississippi constitutes not only sound public health policy overall, but also smart strategies to improve pregnancy outcomes, reduce childhood illnesses and deaths, 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.