Maternal/Congenital Syphilis in a Large Tertiary-Care Urban Hospital

Among the women delivering a total of 9,591 infants in 1990 at Hutzel Hospital in Detroit, 148 had positive results in the rapid plasma reagin (RPR) and fluorescent treponemal antibodyabsorption tests for syphilis. This group included primarily young, black, multigravid women with a history of crack cocaine use. RPR titers ranged from 1:1 to 1:256 among the 103 mothers not treated or inadequately treated for syphilis. Two mothers with very low RPR titers (1:2) delivered a stillborn infant and an infant with a reaction in the cerebrospinal fluid Venereal Disease Research Laboratory (CSF-VDRL) test, respectively. Seventy-five percent of the infants born to untreated or inadequately treated women had asymptomatic congenital syphilis