Table 1.
Summary of Study Characteristics Included in the Narrative Review
| Author | Year | Location | Study Design | Sample Size | Characteristics of mothers who gave birth to an infant with CS | Quality |
|---|---|---|---|---|---|---|
| Mascola L | 1984 | Texas | Cohort | 50 CS infants | African-American (RR 3.5, 95% CI 1.7–7.2) | Good |
| Minkoff HL | 1990 | New York | Case control | 1,206 parturient women | Cocaine use associated with maternal syphilis (OR 9.3l, 95% CI 5.2–16.5) | Good |
| Nanda D | 1990 | New York | Cross-sectional | 81 CS infants | 37% of women had no prenatal care 55% of women had inadequate therapy 40% of women reported substance use 88% of women who used substances reported cocaine use |
Good |
| Greenberg MS | 1991 | New York | Case control | 882 mother-infant pairs | Prenatal care (aOR 0.9, 95% CI 0.88–0.93) Maternal cocaine use (aOR 3.9, 95% CI 2.8–5.3) Maternal alcohol use (aOR 2.1, 95% 1.2–3.4) Single marital status (aOR 2.2, 95% 1.7–2.8) Education less than high school (aOR 1.3, 95% 1.1–1.7) |
Good |
| Desenclos JC | 1992 | Florida | Case control | 492 mother-infant pairs | African American (OR 15.6, 95% CI 4.8–50.4) Maternal substance use (OR 17.4, 95% CI 2.1–141.3) Lack of prenatal care (OR 6.3, 95% CI 2.0–16.7) Younger maternal age (OR 0.90, 95% CI 0.83–0.98) Single marital status (OR 4.6, 95% CI 1.4–14.9) Education less than high school (OR 3.3, 95% 0.8–13.4) |
Good |
| Rawstron SA | 1993 | New York | Case control | 403 pregnant women with syphilis | Protective effect of prenatal care (p<0.001) Protective effect of maternal therapy (p<0.001) High RPR titer (p<0.001) |
Good |
| Reyes MP | 1993 | Michigan | Cross-sectional | 148 mother-CS infant pairs | 95% African American 33% maternal cocaine use |
Fair |
| Webber MP | 1993 | New York | Cohort | 2,229 CS infants | Rates of CS increased the greatest for African American infants and rates were greatest in the highest cocaine exposure quartiles. | Good |
| Webber MP | 1993 | New York | Case control | 223 mother-infant pairs | Lack of prenatal care (aOR 11.0, 95% Cl 1.3–93 1) Maternal cocaine use (aOR 4.9, 95% Cl 1.8–13.0) African American (aOR 2.08, 95% CI 0.80–5.4) |
Good |
| McFarlin BL | 1994 | Michigan | Case control | 253 pregnant women with syphilis | High VDRL titer at diagnosis (p<0.001) | Good |
| Coles FB | 1995 | New York | Cross-sectional | 322 CS infants | 95% of women were of a racial minority (e.g. African American, Hispanic) 46% of women had no prenatal care 38% of women reported substance use 78% of women were < 30 years old 80% of women reported single marital status |
Good |
| Sison CG | 1997 | Michigan | Case control | 1012 infants | Positive meconium drug screen (OR 3.0, 95% CI 1.6–5.7) Positive cocaine screen (OR 3.7, 95% CI 1.9–7.0) |
Good |
| Mobley JA | 1998 | South Carolina | Case control | 673 CS and non-CS infants | African American (aOR 4.5, 95% CI 1.3–15.5) Maternal cocaine use (OR 9.3, 95% CI 2.6–33.1) No prenatal care (aOR 2.7, 95% CI 1.3–5.5) |
Good |
| Southwick KL | 1999 | Texas | Cohort | 91 pregnant women with syphilis | No prenatal care (RR 1.9, 95% CI 1.4–2.8) No syphilis test (RR 2.2, 95% CI 1.5–3.3) Syphilis test in 2nd or 3rd trimester (RR 1.4; 95% CI 0.9–2.2) Maternal cocaine use (RR 1.5, 95% CI 1.1–2.1) |
Good |
| Warner L | 2001 | Georgia | Case control | 157 CS infants | Racial minority (e.g. African American, Hispanic) (OR 5.6, 95% CI 2.5–12.7) Single marital status (OR 3.4, 95% CI 1.9–5.8) Maternal tobacco use (OR 5.8, 95% CI 4.2–7.9) Maternal alcohol use (OR 5.2, 95% CI 3.6–7.3) No prenatal care (OR 4.6, 95% CI 3.3–6.4) |
Good |
| Sheffield JS | 2002 | Texas | Case control | 43 pregnant women with syphilis | High VDRL titers (p=0.005) Treatment < 30 days prior to delivery (p<0.001) |
Good |
| Ogunyemi D | 2004 | California | Case control | 400 mother-infant pairs | Maternal cocaine use (OR 9.29, 95% CI 2.14–40.28) | Good |
| Taylor MM | 2008 | Arizona | Cross-sectional | 131 CS infants | 34% of women had no prenatal care 25% of women received treatment < 30 days prior to delivery 31% of women reported substance use |
Good |
| Kirckaldy RD | 2011 | Arizona | Case control | 242 pregnant women with syphilis | No prenatal care (p<0.001) Test in 1st or 2nd trimester (p<0.001) |
Good |
| Sia VM | 2011 | New York | Cross-sectional | 21 CS infants | 86% poor prenatal care | Fair |
| Patel S | 2012 | New York | Cross-sectional | 195 CS infants | 63% of women had one or more missed opportunities for prevention (late, inappropriate [nonpenicillin], or no therapy) | Good |
| Ghazaryan L | 2014 | New York | Case control | 85 CS infants | Lack of prenatal care (p=0.0338) | Good |
| Kachikis A | 2016 | Georgia | Cross-sectional | 101 CS infants | 61% of women were African American 72.3% of women had one or more missed opportunities for prevention (late, inappropriate [nonpenicillin], or no therapy) 21.8% of women had no prenatal care |
Good |
| Biswas HH | 2018 | California | Case control | 427 mother-infant pairs | No prenatal care (p<0.001) Protective effect of receipt of any prenatal care (p<0.001) First prenatal visit in third trimester (p<0.001) Inadequate testing (none, <40 days before delivery) (p<0.001) Inadequate treatment (no treatment, treatment <30 days prior to delivery, inappropriate for stage of syphilis) (p<0.001) |
Good |
| Veesenmeyer AF | 2018 | California | Cohort | African American vs. Caucasian (RR 5.97; 95% CI 4.36–8.17) Private insurance vs. public insurance (RR 0.29, 95% CI 0.19–0.43) Higher income (>45,000) vs. lower income household (< 25,000) (RR 0.87, 95% CI 0.80–0.94) |
Good | |
| Plotzker R | 2019 | California | Case control | 616 pregnant women with syphilis | Maternal methamphetamine use (p<0.001) | Good |
| Umapathi KK | 2019 | Nationwide | Case control | 5912 CS infants | African American vs. Caucasian (aOR 6.51, 95% CI 5.55–7.64) Private insurance vs. public insurance (aOR 0.24, 95% CI 0.21–0.29) Higher income (>45,000) vs. lower income household (< 25,000) (aOR 0.36, 95% CI 0.29–0.46) |
Good |