Congenital syphilis prevention in the context of methamphetamine use and homelessness

Background and Objectives Congenital syphilis (CS) is increasing in the United States and is associated with intersecting social and structural determinants of health. This study aimed to delineate birthing parent characteristics associated with CS in an adjusted model. Methods (n = 720) People diag...

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Published in:The American journal on addictions 2022-05, Vol.31 (3), p.210-218
Main Authors: Plotzker, Rosalyn E., Burghardt, Nicole O., Murphy, Ryan D., McLean, Rachel, Jacobson, Kathleen, Tang, Eric C., Seidman, Dominika
Format: Article
Language:English
Subjects:
Female
Humans
Ill-Housed Persons
Methamphetamine
Pregnancy
Pregnancy Complications, Infectious - diagnosis
Pregnancy Complications, Infectious - drug therapy
Pregnancy Complications, Infectious - epidemiology
Syphilis - diagnosis
Syphilis - epidemiology
Syphilis - prevention & control
Syphilis, Congenital - drug therapy
Syphilis, Congenital - epidemiology
Syphilis, Congenital - prevention & control
United States
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Summary:Background and Objectives Congenital syphilis (CS) is increasing in the United States and is associated with intersecting social and structural determinants of health. This study aimed to delineate birthing parent characteristics associated with CS in an adjusted model. Methods (n = 720) People diagnosed with syphilis during pregnancy from 2017 to 2018 who were interviewed and linked to infants in the California state surveillance system were included (herein, “birthing parents”). Sociodemographic and clinical CS risk factors informed a stepwise multivariable logistic regression model in which the outcome of interest was infants born with CS. CS prevention continuums delineated the proportion of pregnant people with syphilis who completed steps (e.g., prenatal care entry, syphilis testing, treatment) needed to prevent CS; the outcome was delivering an infant without CS. We stratified continuums by homelessness and methamphetamine use to explore differences in CS outcomes. Results Of 720 birthing parents, 245 (34%) delivered an infant with CS. Although CS was initially associated with homelessness (odds ratio [OR] = 2.5, 95% confidence interval [CI]: 1.6, 4.0) and methamphetamine use (OR = 2.1, 95% CI: 1.4, 3.1), the addition of prenatal care into a final adjusted model attenuated these associations to not significant. In CS prevention continuums, delivering an infant without CS was less likely for people who reported methamphetamine use (p 
ISSN:1055-0496
1521-0391
DOI:10.1111/ajad.13265