What parents should know about two common causes of birth defects

NRHA has partnered with the American Academy of Pediatrics to raise awareness within rural communities the potential of certain birth defects. These resources are intended to help clinicians and families better understand, prevent, and manage congenital syphilis and congenital cytomegalovirus (cCMV).

Things to know about congenital syphilis

Syphilis is a sexually transmitted infection that can spread to a fetus during pregnancy or a newborn during labor. When this happens, it is known as congenital syphilis and can result in miscarriage, stillbirth, infant death or medical issues for the baby, including deafness, blindness, bone deformities and meningitis.

According to the Centers for Disease Control and Prevention, congenital syphilis has tripled in recent years, with more than 3,800 cases reported nationwide in 2023 alone. This is the highest number reported in one year since 1994.

“While serious, congenital syphilis is preventable through timely screenings before and during pregnancy,” says Margaret Ikeda, MD, MS, FAAP, board-certified pediatrician, Yale University School of Medicine, and member of the American Academy of Pediatrics (AAP) Section on Infectious Diseases.

To help pregnant women protect their babies, the AAP is sharing some vital information:

Steps to take during pregnancy

Testing and treatment can help protect your baby. The AAP recommends all pregnant women be tested for syphilis during early pregnancy and that high-risk pregnant women be tested again during the third trimester and at delivery.

If you are diagnosed with syphilis, it is important to receive treatment right away. This should be followed by repeat blood tests to make sure the treatment worked. Since you can be infected at any time during pregnancy, your doctor may do the test more than once.

Steps to take after birth

Newborn babies can also be tested and treated for congenital syphilis. As soon as infection is detected, babies should be treated with antibiotics. After the first treatment, babies will have repeated blood tests over several months to make sure the infection is gone, and occasionally, will need to be treated again.

Signs and symptoms to be aware of

The first stage of acquired syphilis can appear as a painless sore on the genitals a few weeks after exposure, however it often goes unnoticed. Unless treated, the infection can spread throughout the body. Symptoms at this stage can include skin rash, swollen glands, fever, headache, joint aches and fatigue, and can last for months or even come back later if not treated. However, it’s important to understand that you can be infected with syphilis but not feel sick or have any symptoms at all, which is still dangerous for the baby. That’s one reason why testing is so important.

Resources to lean on

The AAP offers comprehensive resources to help ensure pregnant women get needed testing and treatment for themselves and their newborns. Visit https://www.aap.org/congenitalsyphillis to learn more.

“The best thing you can do to protect your baby is to have syphilis blood testing as soon as you discover you are pregnant and throughout pregnancy. If you are diagnosed with the infection, get treatment as soon as possible,” says Yarlini Vipulanandan, MD, Pediatric Infectious Disease Fellow at the University of Alabama in Birmingham and post-residency training member of the AAP.

Things to know about congenital cytomegalovirus

Cytomegalovirus (CMV) is a common virus that infects people of all ages and belongs to the same family as other common viruses like the chicken pox virus. When a pregnant woman catches CMV and the growing fetus becomes infected, this is known as congenital CMV and it impacts about 1 in 200 babies.

While most babies born with cCMV do not develop signs of infection, about 1 in 5 will have birth defects or other long-term health problems, according to the Centers for Disease Control and Prevention. Signs at birth can include rash, jaundice, microcephaly (small head size), low birth weight, enlarged liver and spleen, seizures, and damaged eye retina. Long-term problems can include changes in hearing and vision, developmental and/or motor delay, microcephaly, lack of coordination or weakness, and seizures.

Young children with CMV can spread the virus to their parents. This is why the American Academy of Pediatrics (AAP) offers these tips to parents, childcare providers, and pregnant women to lower their chance of infection:

• Reduce contact with saliva and urine from babies and young children.
• Do not share food, utensils, cups or pacifiers with a child.
• Wash your hands with soap and water after changing diapers or helping a child to use the toilet.

If your newborn is exhibiting signs of cCMV, visit your pediatrician as soon as possible. Testing for cCMV must be done within 2 to 3 weeks after the baby is born. If your baby has cCMV and is exhibiting signs of infection, antivirals can help, though babies who are being treated with these medicines should be closely watched by their doctor for possible side effects.

The AAP offers comprehensive resources for physicians to help them identify cCMV and support treatment of the virus, as well as resources for families and caregivers. Visit https://www.aap.org/ccmv to learn more.

“It’s important to remember that many of us do not know if we have a CMV infection. Even without symptoms, we can spread the virus through body fluids like urine and saliva. Reducing the spread of the virus to those who are pregnant and others at risk of serious illness, as well as knowing the signs of cCMV, is essential,” says Mary T. Caserta, MD, FAAP, professor of pediatrics in infectious diseases at the University of Rochester Medical Center and member of the AAP Committee on Infectious Diseases.

Produced by StatePoint Media in collaboration with the American Academy of Pediatrics and presented in partnership with NRHA.