Year of Publication

2024

College

Public Health

Date Available

4-29-2026

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Kathleen Winter

Committee Member

Mary Lacy Leigh

Committee Member

Ketrell McWhorter

Committee Member

Timothy S. Prince

Abstract

Abstract:

Background: The incidence of congenital syphilis (CS) has increased both in the United States (US) and globally and remains a public health concern. In Kentucky alone, there has been a significant increase in CS cases, from 9 cases in 2019 to 27 cases in 2023. CS is a preventable disease, but testing and immediate treatment are critical to prevent its spread. We have limited knowledge regarding Kentucky’s characteristics and behavioral factors that may be associated with this rise. The goal of this study is to identify characteristics and potential risk factors that contribute to the rise of CS in Kentucky.

Method: A matched case-control study was conducted on congenital syphilis reported women in Kentucky from January 1, 2019, to December 31, 2023, using data from the Infectious Disease Branch and the Office for Vital Statistics at the Kentucky Department of Public Health (KDPH). Mother-infant dyads with congenital syphilis (n=95) were matched 4:1 on infants’ date of birth with mother-infant dyads that were free from syphilis (n=378), resulting in a total sample size of 473 mother-infant dyads. We used fisher's exact test to analyze distributions of categorical variables in bivariate analysis, and logistic regression was used to calculate the unadjusted odds ratio.

Result: The study included 473 mother-infant dyads, 95 cases, and 378 controls. Infants with CS were more likely to be born to mothers who were Black/African American than non-Hispanic White (OR= 3.94, 95%CI: 2.14-7.26), unmarried than married (OR= 8.58, 95% CI: 4.87-15.96) and without a high school diploma than a college degree (OR= 28.2, 95%CI: 8.30-95.61).Mothers who had 1-3 prenatal care visits during their pregnancy had higher odds of CS than mothers with more than 12 visits (OR= 24.6, 95%CI: 8.08-74.82). In our study, there was no correlation between Hispanic mothers and an increased odds of CS.

Conclusion: In conclusion, it is important to focus on reducing socio-economic disparities, enhancing access to prenatal care, and implementing specific interventions to detect and treat syphilis early during pregnancy. Interventions for CS in Kentucky should not only address medical issues but also consider modifying sexually transmitted infection education in various racial/ethnic groups. Furthermore, addressing inadequate prenatal care for women is critical to reducing the serious consequences for both mothers and infants, potentially lowering infant death rates caused by CS.

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Available for download on Wednesday, April 29, 2026

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