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CME Credit Offered
CME Credit Offered
Abstract Award
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Poster Session 4

(1085) Neighborhood Deprivation as a Predictor of Congenital Syphilis

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective:

In the US, congenital syphilis (CS) has increased 464% since 2001, a trend that has been even more pronounced in Louisiana, a place with both high socioeconomic deprivation at the individual and neighborhood levels. Area Deprivation Index (ADI) is a geographic measure of socioeconomic disadvantage that quantifies neighborhood-level limitations to material resources. High ADI is associated with a range of adverse health outcomes. We hypothesize that high ADI is a predictor of CS.

Study Design:

We performed a retrospective cohort study of patients between 18-45 years old with at least one prenatal visit and delivery within a single large health system in Louisiana between 2015-2023. Incomplete charts and those without any prenatal syphilis testing were excluded. Patients were stratified as high ADI if their home address census block ranked above the 75th percentile; controls were those below the highest quartile. CS was defined by Centers for Disease Control case criteria. Baseline and pregnancy characteristics were compared using chi square or Wilcoxon Ranked-Sum test where appropriate. Outcomes were compared by regression analysis controlling for individual level socioeconomic deprivation (indicated by public insurance) generating odds ratio and 95% confidence intervals.

Results:

Among 56,654 pregnancies meeting inclusion criteria, 17,335 patients (30.5%) resided in high deprivation neighborhoods. High ADI residence was associated with younger age, Black race & public insurance (Table). Among 49 positive CS cases, 37 (75.5%, Table) occurred among patients in high ADI census blocks, corresponding with a congenital syphilis rate of 214 per 100,000 live births compared to 30 per 100,000 live births among non-high ADI pregnancies (aOR 5.1, 95% CI 2.7 – 9.8). When analyzed in a continuous fashion, there is a positive correlation between CS and high ADI, with each increasing decile representing an 80% increased risk for CS.

Conclusion:

High neighborhood deprivation was highly associated with congenital syphilis even when controlling for individual-level socioeconomic deprivation.