(1103) Sociodemographic factors associated with surge in syphilis infections in US pregnancies during the COVID-19 pandemic

Retrospective analysis of the United States (US) Centers for Disease Control and Prevention Natality Live Birth database (2016-2020). All births between 4/1/2020 and 12/31/20 were included in the study group (i.e. pandemic group), whereas births between 1/1/16 and 2/29/20 (i.e. pre-pandemic group) comprised the comparison group. We assessed the prevalence of syphilis in pregnancy stratified by multiple maternal SDFs, which were compared between the two time period groups. Statistical analysis included use of Chi-squared test with significance set at P < 0.05.

Results: Of the 18,648,594 births included, 85.4% were in the pre-pandemic group and 14.6% in the pandemic group. The prevalence of syphilis in pregnancy increased by 57% from 12:1,000 births to 18:1,000 births during the COVID-19 pandemic. The highest prevalence of syphilis during the pandemic was seen with similar vulnerable patient population characteristics as in the pre-pandemic group (i.e. individuals with concurrent sexually transmitted infections, tobacco use, age < 24 years old, low education level, Medicaid insurance, late to prenatal care, and non-Hispanic black race) (Table). Nevertheless, a marked increase in syphilis infections was noted in all SDFs subgroups, both those with high and those with low baseline prevalence (Table).

Conclusion: We report on the concerning surge in syphilis infections in pregnancy during the COVID-19 pandemic. Although a marked increase in the prevalence was noted in all SDF subgroups, the disparity in the prevalence of infections was striking, with vulnerable populations being mostly affected. Further study is needed to determine the potential social, behavioral, and educational issues contributing to this surge during the COVID-19 pandemic.