Spike in Congenital Syphilis, Mississippi, USA, 2016-2022

Abstract

In Mississippi, USA, infant hospitalization with congenital syphilis (CS) spiked by 1,000%, from 10 in 2016 to 110 in 2022. To determine the causes of this alarming development, we analyzed Mississippi hospital discharge data to evaluate trends, demographics, outcomes, and risk factors for infants diagnosed with CS hospitalized during 2016–2022. Of the 367 infants hospitalized with a CS diagnosis, 97.6% were newborn, 92.6% were covered by Medicaid, 71.1% were African American, and 58.0% were nonurban residents. Newborns with CS had higher odds of being affected by maternal illicit drug use, being born prematurely (<37 weeks), and having very low birthweight (<1,500 g) than those without CS. Mean length of hospital stay (14.5 days vs. 3.8 days) and mean charges ($56,802 vs. $13,945) were also higher for infants with CS than for those without. To address escalation of CS, Mississippi should invest in comprehensive prenatal care and early treatment of vulnerable populations.

Keywords: Mississippi; Treponema pallidum; United States; bacteria; congenital syphilis; health disparities; neonatal illnesses; prematurity.

Figure 1

Infants hospitalized with congenital syphilis, Mississippi, USA, 2016–2022. A) Number of infants hospitalized by year and race. B) Hospitalization rates for congenital syphilis per 10,000 delivery hospitalizations. Numbers above bars are rates for each year. We obtained the rates by dividing the number of infants hospitalized with congenital syphilis by the total number of delivery hospitalizations per year.

Figure 2

Maternal illicit drug use among newborns with congenital syphilis, Mississippi, USA, 2016–2022.

Figure 3

Mean birthweight for newborns with and without congenital syphilis, Mississippi, USA, 2016–2022. Error bars indicate 95% CIs.