Congenital syphilis in New York City: 1985-1990.

The Bureau of STD Control continues to combat NYC's epidemic of congenital syphilis. The demographic profile of this population has remained constant with only a clearer identification of previously reported risk factors: most notably poor prenatal care and substance abuse. There is a suggestion of a plateau having occurred in adult and congenital syphilis, possibly caused by saturation effect on the high-risk population. During the period 1989 through 1990, the rates for cocaine/crack use have remained relatively constant among mothers infected with syphilis. A recent study by the Division of Substance Abuse Services of New York State school-age children demonstrated a drop in cocaine use from 14% in 1983 to 6%. If a similar decline is seen in substance abuse in other age groups, the rate of congenital syphilis may diminish.