In the case of congenital syphilis, a pregnant woman infected with Treponema pallidum can transmit bacterium to the fetus through the placenta between the 10-15 weeks of gestation. The bacterium can be transmitted transplacental in both symptomatic and asymptomatic stages. Up to 40% of infected and untreated women will transmit the bacterium and can be found in different situations, as follows:
In some cases death occurs in uterus and take place spontaneous abortion, and in others the death of the child at birth.
Other fetus are born alive, but develop signs of congenital syphilis in childhood: hepatosplenomegaly, neonatal jaundice, anemia, optic nerve atrophy, interstitial keratitis, deafness, skeletal anomalies, Hutchinson teeth, saddle nose, periostitis and different CNS anomalies, meningitis. The proper treatment of the mother during pregnancy prevents congenital syphilis.
Although older U.S. national surveillance data showed a decrease in congenital syphilis from 10.5 to 8.4 cases to 100,000 newborn live births in the period 2008-2012, in 2014 were registered the highest incidence of 2001, 11.4 (Increase in incidence of congenital syphilis-United States, 2012-2014).
Recent studies published in 2015 confirm in a large report that after a long period of decline, in the period 2012-2014, the study ;period, incidence of congenital syphilis increased to higher alarm rates than even 15 years ago. Growth has been observed in all races, ethnicities and religions.
Virginia Bowen, John Su, Elizabeth Torrone, Sarah Kidd, Hillard Weinstock, increase in Incidence of congenital Syphilis — United States, 2012 – 2014: Morbidity and Mortality weekly Report. 2015; 64 (44): 1241-1245. Http://www.medscape.com/viewarticle/865770?src=par_cdc_stm_mscpedt&faf=1
Data published in 2016 at the WHO initiative, launched in 2007, to eliminate the congenital infection with syphilis worldwide, show for 2008 that from the 1.4 million women infected at birth with Treponema pallidum in 520 000 cases there were damages of various degrees. Also in this study expanded to 2012 were reported 930 000 cases of maternal syphilis, which led to 143 000 of fetal deaths, 62 000 of neonatal deaths and 102 000 infected babies.
Wijesooriya NS, Rocha RW, Kamb ML. Global burden of maternal and congenital syphilis in 2008 and 2012: A Health systems modelling study. The Lancet Global Health. 2016 Aug 31; 4 (8): e525-533, two: http://dx.doi.org/10.1016/S2214-109X (16) 30135-8
According to a study conducted in China in 2013, of 15884 pregnant and infected women with Treponema pallidum, 79.1% consulted a doctor before week 37 of gestation, and 55.4% did not follow any treatment or started treatment after week 37. The rate of congenital syphilis was 3% and the neonatal death of 2.9%.
(Two L, Wang X, Wang F, et al. Epidemic profile of maternal syphilis in China in 2013. BioMed Research International. 2016 Feb 11; 2016).
About Corneliu Zaharia
