Texas can do more to stop syphilis in newborns

Every day a baby is born with syphilis is a tragedy. Not only for the mothers who might have avoided this outcome, but for those in charge of public policy who could have done more to prevent it.

Health officials nationwide sounded the alarm last week after reporting a significant jump in newborn syphilis cases. This is a disease that can be remedied early in pregnancy. But if left untreated it can lead to infant deaths, stillbirths and miscarriages.

More than 3,700 babies in the United States were born with congenital syphilis in 2022, according to the Centers for Disease Control and Prevention. This is a 32% increase from the previous year. In Texas, the numbers are also remarkable: a 39% spike in 2020-21, compared with the previous biannual report, according to the Department of Health and Human Services.

While some experts are pointing to reduced preventive medical care and testing during the pandemic as the reasons behind this jump, Dr. Philip Huang, Dallas County health director, noted that sexually transmitted diseases were steadily on the rise even before COVID-19 upended health care.

There are multiple factors for the rise of syphilis in newborns, including a lack of transportation and child care options for child-bearing mothers. But the lack of affordable health insurance is an overarching reason.

In a state where 18% of the population is uninsured and where Texas is one of 10 hold-out states avoiding Medicaid expansion, the prevalence of congenital syphilis should not come as a surprise given the social and economic factors that are preventing low-income women from receiving prenatal care.

Congenital syphilis can result in the baby’s death up to 40% of the time, but chances drop to 2% if the pregnant mother receives treatment with antibiotics. Yet, this simple solution is out of reach for many. Nearly half of Texas counties are maternity care deserts, according to a 2022 March of Dimes report. Even in southern Dallas County, there are areas where access to health care services is an issue.

“If a mom has to choose between paying the rent and going for a [doctor] visit, they will pay the rent so they’re going to be missing a visit,” said Yolande Pengentze, a pediatrician and leading physician-scientist at Parkland Services for Clinical Innovation.

PCCI, which develops data-driven solutions for Parkland Health, has a program that identifies pregnant women at higher risk of preterm birth, and it is already yielding some results. It has helped reduce preterm birthrates by 20% and has increased prenatal doctor visits by 8% to 15%, Pengentze told us.

Having this data available allows Parkland to target specific groups. The county health system has also added more community clinics, telemedicine options and information campaigns.

Finding solutions at the community level is a sensible approach, but Texas must look for ways to expand health care access for all. Too many are falling through the cracks, and in a state that boasts its economic miracle, this is unacceptable.

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