Menza Tim W, Zlot Amy, Gonzalez-Pena Yuritzy, Cicognani Cedric, Pearson Shelley, Li Jennifer, Garai Jillian
HIV/STD/TB Section of the Public Health, Division of the Oregon Health Authority, Portland, OR.
Sex Transm Dis. 2025 Jan 1;52(1):1-8. doi: 10.1097/OLQ.0000000000002071. Epub 2024 Sep 2.
Despite the availability of curative penicillin treatment for syphilis during pregnancy, congenital syphilis (CS) cases have surged in the United States, including in Oregon.
We conducted a retrospective analysis of individual- and county-level predictors of CS among pregnant people with syphilis in Oregon from 2013 to 2021. Data were collated from surveillance reports, County Health Rankings, and other sources with upstream county-level data. We used multilevel Poisson regression models to assess associations between CS and individual- and county-level factors.
Among 343 people with syphilis during pregnancy, 95 (27.6%) were associated with a case of CS. At the individual level, a history of injection drug use and a history of corrections involvement were associated with an increased risk of CS, whereas a recent gonorrhea diagnosis was associated with a decreased risk of CS. County-level violent crime rate, unemployment, income inequality, and adverse childhood experiences increased the risk of CS. Higher county-level socioenvironmental challenges exacerbated CS risk, particularly among people with corrections involvement.
Injection drug use, corrections involvement, and county-level socioenvironmental challenges increased CS risk among pregnant people with syphilis in Oregon. Urgent interventions are needed, including innovative care models, policy reforms targeting systemic issues, and enhanced collaboration with community services to address the escalating CS crisis.
尽管孕期梅毒有可用的青霉素治愈性治疗方法,但美国包括俄勒冈州在内的先天性梅毒(CS)病例仍激增。
我们对2013年至2021年俄勒冈州梅毒孕妇中CS的个体和县级预测因素进行了回顾性分析。数据来自监测报告、县健康排名以及其他包含上游县级数据的来源。我们使用多层泊松回归模型来评估CS与个体及县级因素之间的关联。
在343名孕期梅毒患者中,95例(27.6%)与CS病例相关。在个体层面,注射吸毒史和有惩教机构服刑经历与CS风险增加相关,而近期淋病诊断与CS风险降低相关。县级暴力犯罪率、失业率、收入不平等以及儿童期不良经历增加了CS风险。县级社会环境挑战加剧会增加CS风险,尤其是在有惩教机构服刑经历的人群中。
注射吸毒、有惩教机构服刑经历以及县级社会环境挑战增加了俄勒冈州梅毒孕妇的CS风险。需要采取紧急干预措施,包括创新护理模式、针对系统性问题的政策改革以及加强与社区服务的合作,以应对不断升级的CS危机。