Disproportionate Rise in Congenital Syphilis Compared with Adult Syphilis Trends in Texas, United States: A Population-Based Analysis, 2016-2023.

OBJECTIVE

This study aimed to compare temporal trends in congenital syphilis with adult primary and secondary syphilis incidence in Texas, United States.

STUDY

DESIGN

Population-based retrospective trend analysis using Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data from 2016 to 2023.

RESULTS

Congenital syphilis incidence increased from 17.5 to 238.6 per 100,000 live births, representing a 12.6-fold increase. The annual percent change (APC) was 29.7% (95% CI: 27.9-31.6; p < 0.001). Adult primary and secondary syphilis increased from 7.0 to 15.0 per 100,000 population (113% increase), with an APC of 13.1% (95% CI: 12.5-13.8; p < 0.001). The increase in congenital syphilis significantly outpaced adult trends (interaction p < 0.001).

CONCLUSION

Congenital syphilis in Texas, United States, has increased at a markedly greater rate than adult syphilis, suggesting failures in prenatal screening, treatment, or care access beyond rising community transmission alone.

KEY POINTS: · Congenital syphilis in Texas, United States, increased 12.6-fold from 2016 to 2023.. · Congenital syphilis rates rose faster than adult syphilis, indicating system failures.. · Findings highlight gaps in prenatal screening, treatment, and care access..