METHODS: We identified pregnant women with all stages of syphilis reported to the California Department of Public Health during January 2013–June 2015. We described demographics and clinical care of women who delivered an infant with CS (CS mothers). Among interviewed pregnant women with early syphilis, we compared behavioral risk factors between CS mothers and women who did not deliver an infant with CS (non-CS mothers) by using chi-square tests.
RESULTS: Among 158 CS mothers, 92 (58%) received prenatal care; of these, 15 (16%) had adequate, 45 (49%) inadequate, and 32 (35%) unknown treatment. Compared with non-CS mothers (n = 90), CS mothers (n = 28) more frequently reported methamphetamine use (13 [46%] versus 21 [23%]; P <.01), sex while intoxicated or high (12 [43%] versus 22 [24%]; P <.05), anonymous sex partner(s) (9 [32%] versus 10 [11%]; P <.01), and sex partner(s) who had been incarcerated during the past 12 months (13 [46%] versus 26 [29%]; P <.01).
CONCLUSIONS: Lack of prenatal care and inadequate treatment were common among CS mothers. Substance abuse and risky sexual behavior were associated with delivering an infant with CS. Early identification of syphilis through prenatal screening, including repeat screening of women at high risk, and adequate treatment are critical for preventing CS. Additional strategies are needed to ensure women at high risk receive comprehensive prenatal care.