Document 0634
 DOCN  M95A0634
 TI    Congenital syphilis in infants of adolescent mothers. American Pediatric
       Society 104th annual meeting and Society for Pediatric Research 63rd
       annual meeting; 1994 May 2-5; Seattle.
 DT    9510
 AU    Risser WL; Hwang LY; Dept. of Peds., Univ. of Texas Health Sciences
       Center, Houston,; USA.
 SO    Pediatr AIDS HIV Infect. 1994 Oct;5(5):316 (unnumbered abstract). Unique
       Identifier : AIDSLINE AIDS/95330410
 AB    OBJECTIVE: To characterize adolescent mothers who had syphilis during
       pregnancy; determine the incidence of congenital syphilis (CS) in their
       infants; and assess risk factors for their failure to receive successful
       treatment during pregnancy. DESIGN: Retrospective cohort study using
       data of the Houston Health and Human Services Dept. SETTING: Harris
       County, TX. PATIENTS: Mothers < 20 years old who had syphilis during
       pregnancy in 1990-92. MEASUREMENTS AND MAIN RESULTS: Applying the
       classification guidelines of the CDC, we determined that 269 mothers had
       syphilis during pregnancy: 45/223 (20.2%) received no prenatal care;
       69/269 (24.7%) had equivocal serologic responses to therapy; 144/162
       (88.9%) were black & 172/188 (91.5) single; 120/160 (75%) had primary or
       secondary syphilis; 7/112 (6.3%) used crack, 3/112 (2.7%) traded sex for
       drugs; and 7 were HIV-positive. Of the 269 infected mothers, 147 (54.6%)
       had 127 live- and 20 stillborn infants with CS. Of the variables listed
       above, in both univariate and multivariate analyses the only significant
       risk factors for failure to prevent CS in infants of infected mothers
       were: lack of prenatal care [multivariate odds ratio (OR) = 5.75, 95%
       confidence intervals (CI) = 2.27, 14.6] and equivocal response to
       therapy (OR = 6.41, CI = 2.75, 14.9). CONCLUSIONS: The high incidence of
       CS among infants of mothers < 20 yrs old who had syphilis during
       pregnancy was the result of lack of prenatal care, as expected, and
       equivocal response to treatment, an artefact of the CDC's case
       definition. The prevalence of HIV infection in these girls was high, but
       few admitted to crack use, a factor that has contributed elsewhere to
       the increasing incidence of CS.
 DE    Adolescence  Female  Human  HIV Seropositivity/COMPLICATIONS  Pregnancy
       *Pregnancy in Adolescence  Pregnancy Complications, Infectious  Prenatal
       Care  Sex Behavior  Substance Abuse/COMPLICATIONS
       *Syphilis/COMPLICATIONS  *Syphilis, Congenital/TRANSMISSION  MEETING
       ABSTRACT  JOURNAL ARTICLE

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