From 1986 through 1988, the number of reported1 cases of congenital syphilis (CS) in New York City (NYC) increased >500%, from 57 to 357. From January through June, 1989, 779 newborns with reactive serologic tests for syphilis were reported. Based on previous NYC data, an estimated 57%-68% of these infants represent true congenitally acquired infections, which projects to 888-1059 CS cases for 1989.* Because syphilis has been associated with use of crack cocaine, the NYC Department of Health conducted a case-control study to examine the relationship between maternal cocaine/crack use** and CS cases in 1988 in NYC.
Data were obtained from NYC birth certificates and an attached Confidential Medical Section containing maternal drug-use information collected routinely by a trained registrar on all mothers at delivery. Additional information on cocaine/crack use was obtained by health department personnel investigating CS reports.
Of the 357 CS cases in 1988, 302 (85%) (including