Characterization of gestational and congenital syphilis at a university clinic in Medellín, Colombia

Abstract

Objective: to describe the clinical, epidemiological and laboratory characteristics in mothers with gestational syphilis (GS) and their newborns with highly probable congenital syphilis (CS).

Methods: descriptive observational study which includes all newborns (NB) and their mothers with diagnosis of GS and GS treated at the Bolivarian University Clinic from Medellin, Colombia, from 1/01/2017 to 31/12/2021.

Results: 71 NB and their mothers were diagnosed with syphilis and 22 cases of highly probable CS were identified. Of 22 pregnant women, 58.1 % were under 26 years of age and 18.1 % ≤18 years of age. All mothers were affiliated to healthcare system, however 40.1 % did not have prenatal visits. Syphilis was most commonly diagnosed in the third trimester (59 %) and the most frequent clinical presentations during pregnancy were unknown duration (45.4 %), early latent (27.2 %), and secondary (13.6 %). Obstetric ultrasound was performed in 63.6 % (14/22), of those, 37.5% reported findings suggestive of fetal syphilis. 54.5 % of the mothers received treatment with penicillin, in 16.6 % it was given up to 30 days before delivery, 16.6 % presented therapeutic failure. Treatment for the partner was not given or not recorded in 77.2 %. Of 22 NB with CS, 50% were premature, 63.6 % weighed <2500g, 72.7 % presented clinical manifestations and 7 (31.8 %) were children of adequately treated mothers.

Conclusion: in this group of pregnant women, young women and adolescents predominated, there was a high misattendance to prenatal visit, late diagnosis and underreporting of treatment to their partners. Prematurity and low birth weight predominated in newborns and 7 neonates were children of mothers with adequate treatment, which suggests therapeutic failure that could be related to late treatment or stages of syphilis.