{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:08:09Z","timestamp":1780628889009,"version":"3.54.1"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T00:00:00Z","timestamp":1715472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100007268","name":"Washington University Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007268","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012729","name":"Clinical and Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012729","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002345"],"award-info":[{"award-number":["UL1TR002345"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Congenital syphilis disproportionately affects individuals impacted by adverse social determinants of health. Understanding these determinants may help facilitate holistic care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a retrospective review of mother-infant dyads with potential congenital syphilis in a Missouri hospital system. Cases were classified per Centers for Disease Control and Prevention clinical scenarios. Information was collected regarding demographics, prenatal care, substance use, and other social factors. Dyads with confirmed\/highly probable or possible congenital syphilis (\u201ccongenital syphilis outcomes\u201d) were compared to those with less likely\/unlikely congenital syphilis (\u201cnoncongenital syphilis outcomes\u201d) using descriptive statistics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 131 dyads with infant dates of birth from 2015 to 2022: 74 (56%) with congenital syphilis outcomes and 56 (43%) with noncongenital syphilis outcomes. Most mothers were Black\/African American (n = 84 [65%]) and lived in areas with a high Social Vulnerability Index. Many had inadequate prenatal care (n = 61 [47%]) and\/or had substance use histories (n = 55 [42%]). Significant associations (odds ratio [95% confidence interval]) with congenital syphilis outcomes included limited prenatal care (3.01 [1.38\u20136.56]), no prenatal care (16.08 [1.96\u2013132.11]), substance use (3.42 [1.61\u20137.25]), housing instability (3.42 [1.39\u20138.38]), and justice system interactions (2.29 [1.00\u20135.24]). Substance use correlated with prenatal care adequacy (P &amp;lt; .001). One-third of infants with congenital syphilis outcomes were taken into protective custody.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Adverse social determinants of health are common in dyads impacted by congenital syphilis. Health systems should consider interdisciplinary programming to improve testing and linkage to care. Future studies should evaluate social support for congenital syphilis prevention and management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae260","type":"journal-article","created":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T10:55:41Z","timestamp":1715511341000},"page":"744-750","source":"Crossref","is-referenced-by-count":11,"title":["Social Factors Associated With Congenital Syphilis in Missouri"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-0562","authenticated-orcid":false,"given":"Elizabeth","family":"Daniels","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Washington University School of Medicine , St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University School of Medicine , St Louis, Missouri"},{"name":"Paediatric Research Centre, University Children's Hospital Basel , University of Basel, Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Cardoza","sequence":"additional","affiliation":[{"name":"Institute for Public Health , Washington University in St. Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0843-1414","authenticated-orcid":false,"given":"Aditi","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University School of Medicine , St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Willers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Washington University School of Medicine , St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4979-5492","authenticated-orcid":false,"given":"Hilary","family":"Reno","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University School of Medicine , St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,12]]},"reference":[{"key":"2024092615371165300_ciae260-B1","first-page":"1","article-title":"Sexually transmitted infections treatment guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024092615371165300_ciae260-B2","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1056\/NEJMc2111103","article-title":"High congenital syphilis case counts among U.S. infants born in 2020","volume":"385","author":"Bowen","year":"2021","journal-title":"N Engl J Med"},{"key":"2024092615371165300_ciae260-B3","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.15585\/mmwr.mm7246e1","article-title":"Vital signs: missed opportunities for preventing congenital syphilis\u2014United States, 2022","volume":"72","author":"McDonald","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024092615371165300_ciae260-B4","volume-title":"Sexually transmitted infections surveillance, 2022","author":"Centers for Disease Control and Prevention (CDC)","year":"2024"},{"key":"2024092615371165300_ciae260-B5","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s12879-022-07100-3","article-title":"Gaps in the congenital syphilis prevention cascade: qualitative findings from Kern County, California","volume":"22","author":"Park","year":"2022","journal-title":"BMC Infect Dis"},{"key":"2024092615371165300_ciae260-B6","doi-asserted-by":"crossref","first-page":"661","DOI":"10.15585\/mmwr.mm6922a1","article-title":"Missed opportunities for prevention of congenital syphilis\u2014United States, 2018","volume":"69","author":"Kimball","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024092615371165300_ciae260-B7","volume-title":"Red Book: 2021\u20132024 report of the Committee on Infectious Diseases. 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