County and pediatricians plan a deeper outreach to at-risk pregnant women. 'They are really a sentinel event.'
Dismayed by the latest case counts, and the lack of prenatal care they suggest, local pediatricians and public health leaders are working to decrease the number of babies born with syphilis across San Diego County.
An increase in the number of newborns with this disease means that too many women are going through pregnancy without comprehensive prenatal care, notes Dr. Winston Tilghman, medical director of the county public health department’s HIV, STD and Hepatitis Branch. However, 2020 is the most recent year for which statewide county-level data is available. Case counts and rates for 2021 and 2022 are available by special request in San Diego but have not yet been formally published. It’s impossible, then, to know how the region’s much-higher rates of 76.8 and 90.3 cases per 100,000 live births in 2021 and 2022 compare to other regions.
is detected in San Diego County was not available. Some mothers, Tilghman said in an interview, refused to be interviewed or to answer some questions posed by interviewers. However, an analysis of interviews showed that mothers of half of the 30 cases in 2021 tested positive in labor and delivery. Nine reported substance abuse while fewer than five reported incarceration or homelessness. Thirteen said they had received prenatal care at least once inside or outside the U.S.
Dr. Richard Silva, a hospital-based newborn specialist at UC San Diego Health and a local physician champion for the AAP, said that an increasing number of local hospitals are working to do more syphilis testing at birth when risk factors are present and especially if there is no record of prenatal care.
While the testing is necessary to determine what complications a child may have later in life, separating parents and children so soon after birth is painful.
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