472 - Rising Cases of Congenital Syphilis in Amarillo: A Two-Year Review of Social and Healthcare Inequities

Publication Number: 2460.472

AISHWARYA NAIR, Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX, United States; Vidhya Ravichandran, Texas Tech University Health Sciences Center, Amarillo, TX, United States; Vaibhavi V. Jaywant, TTUHSC, Amarillo, TX, United States; Olubukunola A. Adesanya, Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX, United States

Background: Congenital syphilis (CS) remains a preventable condition, yet its incidence continues to rise across the United States. Texas continues to experience a steep rise in congenital syphilis, with 922 cases reported in 2022, marking a 34% increase from the previous year. This corresponds to a rate of 230 cases per 100,000 live births, placing Texas first in total case count and fourth nationally in rate. Contributing factors often include limited prenatal care, socioeconomic disadvantage, and structural barriers to sexual health services. Understanding local trends is essential to target prevention and improve maternal care pathways.

Objective: Analyze maternal and sociodemographic factors contributing to congenital syphilis in Texas Panhandle.

Design/Methods: Retrospective review of congenital syphilis cases between 2022-23, across two delivery hospitals in Texas Panhandle for maternal demographics, prenatal care history, comorbidities, and social determinants of health were analyzed to identify gaps in prevention and access to care.

Results: Between 2022 and 2023, a total of 20 infants were diagnosed with congenital syphilis (CS) across two main delivery hospitals serving two major counties, Potter and Randall County, Texas (7 cases in 2022 and 13 in 2023). Maternal ages ranged from 19–35 years, with 70% between 19–29 years. Nearly all mothers had late (90%) or no (10%) access to prenatal care at the time of delivery.
Comorbid social and medical factors were prevalent: 45% of mothers had another sexually transmitted infection, 100% were low-income or unemployed, 85% had limited formal education, 15% had a psychiatric illness, and 80% reported substance use during pregnancy. None of the partners of affected mothers had documented syphilis treatment.
Overall, 75% of primary and secondary syphilis cases leading to congenital syphilis occurred among Hispanic and non-Hispanic Black women, compared with substantially fewer cases among non-Hispanic White women.

Conclusion(s): The growing burden of congenital syphilis in the Texas Panhandle parallels national patterns and reflects profound inequities in access to prenatal and sexual health care. Barriers such as lack of health insurance, socioeconomic disadvantage, maternal mental health conditions, and substance use likely contributed to inadequate prenatal care and delayed management of maternal syphilis. Targeted community outreach, early screening, management, treatment of partners, and culturally responsive public health interventions are essential to reduce this preventable burden and promote health equity.