Key Takeaways
- In 2022, the United States recorded 3,755 cases of congenital syphilis among babies, equating to a rate of 107.9 cases per 100,000 live births, marking an 80% increase since 2019.
- Globally, WHO estimates 661,000 congenital syphilis cases in 2022, with over 380,000 associated fetal or neonatal deaths.
- In the UK, 2021 saw 75 cases of congenital syphilis in babies, up from 48 in 2020 per Public Health England data.
- Among US infants under 1 year, syphilis infection rate was 80.4 per 100,000 in 2022 per CDC.
- Black/African American babies comprised 1,755 (47%) of 2022 US congenital syphilis cases.
- Hispanic/Latino infants accounted for 1,755 (47%) of congenital syphilis cases in US 2022.
- Congenital syphilis transmission rate 70-100% if mother primary syphilis untreated.
- Maternal gonorrhea increases preterm birth risk by 2.4-fold, facilitating congenital infection.
- Chlamydia trachomatis vertical transmission rate 50% intrapartum to conjunctiva/neonatal pneumonia.
- Congenital syphilis rates tripled in US from 2016-2022 due to inadequate screening.
- Global congenital syphilis cases rose 37% from 2016 to 2022 per WHO estimates.
- US congenital syphilis increased 281% from 2016 (1,305 cases) to 2022 (3,755).
- In Texas, congenital syphilis cases tripled from 2018 (281) to 2022 (968).
- California's congenital syphilis rate highest nationally at 260.5/100k in 2022.
- Southwest US: 40% of national congenital syphilis cases in 2022.
Congenital syphilis cases are rising alarmingly in the United States and globally.
Demographic Breakdowns
- Among US infants under 1 year, syphilis infection rate was 80.4 per 100,000 in 2022 per CDC.
- Black/African American babies comprised 1,755 (47%) of 2022 US congenital syphilis cases.
- Hispanic/Latino infants accounted for 1,755 (47%) of congenital syphilis cases in US 2022.
- White non-Hispanic babies: only 3% of US congenital syphilis cases in 2022 (113 cases).
- Mothers aged 20-24 years gave birth to 32% of congenital syphilis cases in US 2022.
- 53% of congenital syphilis cases in US 2022 born to mothers aged 25+ years.
- Urban areas saw 80% of US congenital syphilis cases in 2022, rural 20%.
- In congenital gonorrhea US cases, 60% among Black infants per 2022 CDC data.
- Neonatal chlamydia highest in adolescents' offspring: 40% of cases from moms <20.
- Perinatal HIV transmission risk 15-45% without intervention, higher in low-income demographics.
- Neonatal HSV more common in female infants (55%) per CDC surveillance.
- Congenital syphilis 2x higher in American Indian/Alaska Native babies vs average in 2022.
- Among US teen moms (15-19), 25% of congenital syphilis cases originated in 2022.
- Single mothers accounted for 85% of congenital syphilis deliveries in US 2022 study.
- Low socioeconomic status linked to 70% of congenital STD cases in urban US cohorts.
- In global data, 90% of congenital syphilis in low/middle-income countries affects indigenous groups.
- US congenital gonorrhea 3x higher in Southern states among Black populations.
- Neonatal chlamydia pneumonia 15% higher in preterm infants per cohort studies.
- Perinatal HIV 80% preventable, but 25% failure in substance-using mothers.
- Neonatal HSV dissemination 30% more likely in premature babies <32 weeks.
- Congenital syphilis 4x rate in uninsured mothers per US data 2022.
- Among incarcerated mothers, congenital syphilis risk 10x higher per study.
- Rural Black infants: 5x congenital STD rate vs urban whites in US South.
- Adolescent pregnancy with untreated STDs: 50% transmission to neonate.
Demographic Breakdowns Interpretation
Prevalence and Incidence Rates
- In 2022, the United States recorded 3,755 cases of congenital syphilis among babies, equating to a rate of 107.9 cases per 100,000 live births, marking an 80% increase since 2019.
- Globally, WHO estimates 661,000 congenital syphilis cases in 2022, with over 380,000 associated fetal or neonatal deaths.
- In the UK, 2021 saw 75 cases of congenital syphilis in babies, up from 48 in 2020 per Public Health England data.
- Australia reported 25 cases of congenital syphilis in 2021, with a rate of 1.0 per 100,000 live births according to Kirby Institute.
- South Africa had an estimated 6,000 congenital syphilis cases in 2020, representing 1.5% of live births per WHO regional data.
- Brazil's Ministry of Health noted 25,000 congenital syphilis notifications in 2022, a 20% rise from prior year.
- In California, 2022 congenital syphilis cases reached 601, the highest state total at 260.5 per 100,000 live births.
- Texas reported 968 congenital syphilis cases in 2022, with a rate of 223.3 per 100,000 live births per CDC.
- Florida had 324 congenital syphilis cases in babies in 2022, rate of 118.4 per 100,000 live births.
- New York state logged 138 congenital syphilis cases in 2022, up 50% from 2021.
- Congenital gonorrhea cases in US newborns totaled 24,043 in 2022 per CDC surveillance.
- Neonatal chlamydia infections affected approximately 100,000 US infants annually, often asymptomatically per AAP.
- Perinatal HIV transmission occurred in 121 US infants in 2021, down 10% from 2020.
- Neonatal herpes simplex virus (HSV) infections number about 1,500 cases yearly in the US.
- Congenital hepatitis B in US babies estimated at 1,000 cases per year without vaccination.
- In Europe, congenital syphilis incidence was 1.7 per 100,000 live births in 2021 per ECDC.
- China's 2020 data showed 38,370 congenital syphilis cases, rate of 17.8 per 100,000.
- India estimated 200,000 congenital syphilis cases annually per Lancet study.
- Congenital syphilis in sub-Saharan Africa affects 50-70% of untreated maternal cases per WHO.
- US congenital syphilis stillbirths numbered 496 in 2022 per CDC.
- Neonatal gonorrhea ophthalmia rates in US: 0.3% of live births screened in 2020.
- Congenital chlamydia pneumonia in infants: 10-20% of infected newborns per Pediatrics journal.
- Perinatal HIV cases globally: 110,000 in 2022 per UNAIDS.
- Neonatal HSV mortality rate: 60% if disseminated per CDC.
- Congenital syphilis neonatal death rate: 11% in US 2022 cases.
- In Arizona, congenital syphilis rate hit 450 per 100,000 live births in 2022.
- Louisiana congenital syphilis cases: 466 in 2022, rate 320.3 per 100k.
- Nevada reported 97 congenital syphilis cases in 2022, highest rate at 340.5 per 100k.
- Oklahoma had 230 congenital syphilis cases in 2022, rate 252.2 per 100k.
- Congenital syphilis in Mississippi: 126 cases in 2022, rate 187.1 per 100k live births.
Prevalence and Incidence Rates Interpretation
Regional and Global Variations
- In Texas, congenital syphilis cases tripled from 2018 (281) to 2022 (968).
- California's congenital syphilis rate highest nationally at 260.5/100k in 2022.
- Southwest US: 40% of national congenital syphilis cases in 2022.
- Midwest US congenital syphilis lowest at 30.2/100k live births 2022.
- Africa WHO region: 43% of global congenital syphilis burden in 2022.
- Western Pacific region congenital syphilis: 200,000 cases annually per WHO.
- Southeast Asia: 25% of world congenital syphilis cases estimated 2022.
- Brazil: highest in Americas with 25,000 congenital syphilis cases 2022.
- Argentina congenital syphilis rate 150/100k live births in 2021.
- South Africa: 15,000 congenital syphilis cases yearly, 3% live births affected.
- Nevada state: highest US rate 340.5/100k congenital syphilis 2022.
- New Mexico congenital syphilis 250/100k, 2nd highest US 2022.
- Europe overall: 0.5-2/100k congenital syphilis vs US 100+/100k.
- Russia reported 300 congenital syphilis cases 2021, rate 4/100k.
- Japan congenital syphilis very low <1/100k due to screening.
- Ethiopia: congenital syphilis 2.5% prevalence in antenatal clinics.
- Nigeria neonatal sepsis from syphilis: 11% of cases in Lagos study.
- Canada congenital syphilis 20 cases 2022, rate 0.5/100k.
- Mexico: 8,000 congenital syphilis cases 2022, rate 40/100k.
Regional and Global Variations Interpretation
Transmission and Risk Factors
- Congenital syphilis transmission rate 70-100% if mother primary syphilis untreated.
- Maternal gonorrhea increases preterm birth risk by 2.4-fold, facilitating congenital infection.
- Chlamydia trachomatis vertical transmission rate 50% intrapartum to conjunctiva/neonatal pneumonia.
- Untreated maternal HIV: 15-45% transmission risk to infant via placenta/breast milk.
- Genital herpes (HSV-2) sheds asymptomatically, 1-3% daily risk near delivery for neonatal transmission.
- Late prenatal care increases congenital syphilis risk by 3x per CDC analysis.
- Drug use in pregnancy correlates with 40% higher STD transmission rates to neonates.
- Multiple sexual partners in mother: 5x risk of congenital syphilis per study.
- No prenatal STD screening: 89% of 2022 US congenital syphilis cases per CDC.
- Maternal primary syphilis stage: 100% transmission if untreated at delivery.
- Gonococcal pharyngitis in neonates from maternal oropharyngeal infection: 20-30% risk.
- Chlamydia ascending infection risk post-membrane rupture: doubles neonatal pneumonia odds.
- HIV viral load >1,000 copies/mL: 25% transmission risk despite ART.
- HSV primary outbreak at delivery: 50% neonatal transmission risk.
- Smoking in pregnancy: 1.8x risk of congenital chlamydia complications.
- Domestic violence history: 2.5x untreated STD rate leading to congenital transmission.
- Coinfection syphilis/HIV in mother: 2x transmission efficiency to infant.
- Prolonged rupture of membranes >24h with maternal gonorrhea: 40% neonatal infection.
- Breastfeeding with untreated maternal hepatitis B: 10-20% transmission without vaccine.
Transmission and Risk Factors Interpretation
Trends and Changes Over Time
- Congenital syphilis rates tripled in US from 2016-2022 due to inadequate screening.
- Global congenital syphilis cases rose 37% from 2016 to 2022 per WHO estimates.
- US congenital syphilis increased 281% from 2016 (1,305 cases) to 2022 (3,755).
- Neonatal gonorrhea cases up 62% in US infants 2018-2022 per CDC.
- Perinatal HIV transmissions declined 90% in US since 1990s peak due to ART.
- Neonatal HSV cases stable at 1 in 3,200 deliveries in US over last decade.
- Congenital chlamydia detections dropped 15% 2019-2022 due to COVID lockdowns.
- Europe congenital syphilis up 42% 2017-2021 per ECDC surveillance.
- China's congenital syphilis incidence fell 85% from 2009 peak to 2020 (17.8/100k).
- Latin America congenital syphilis notifications up 170% 2010-2020 per PAHO.
- US South congenital syphilis rates rose 30% yearly 2019-2022.
- Congenital syphilis stillbirths doubled in US 2020-2022 (496 cases).
- Global perinatal HIV down 62% since 2010 per UNAIDS.
- Neonatal gonorrhea ophthalmia declined 50% post-erythromycin prophylaxis routine.
- UK congenital syphilis cases surged 150% 2010-2021.
- Australia saw congenital syphilis rise from 10 to 25 cases 2018-2021.
- India congenital syphilis estimated down 20% with screening scale-up 2015-2022.
- Sub-Saharan Africa congenital syphilis stable high at 300,000/year despite efforts.
- US congenital syphilis in teens dropped 10% 2021-2022 with better care.
Trends and Changes Over Time Interpretation
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