Sexually transmitted diseases · 2026
Gaps in Syphilis Screening Among Pregnant Women in North Carolina.
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Sweitzer Stephanie F, Samoff Erika, Mobley Victoria, Cope Anna B, Seña Arlene C
Аннотация
BACKGROUND: Congenital syphilis rates have risen nationally and in North Carolina (NC). We assessed syphilis screening among pregnant women in NC.
METHODS: A retrospective chart review was conducted among patients with a pregnancy episode-created at first prenatal care encounter or labor/delivery-at an NC health system from January 1, 2019 to December 31, 2023. We estimated the proportion with syphilis screening at timepoints required by NC law (before 28 weeks of gestation, 28-31 weeks of gestation, and within 1 week of delivery) using syphilis test dates and delivery dates. We estimated prevalence ratios (PR) and 95% confidence intervals (CIs) using log binomial regression with generalized estimating equations to explore associations between clinical and sociodemographic factors and syphilis screening.
RESULTS: We identified 64,803 pregnancies among 54,446 patients. Syphilis screening was conducted at least once in 99.5% of pregnancies. Only 27.6% had syphilis screening recorded at 28 to 31 weeks, and 22.0% had all required syphilis screening. Completion of required syphilis screening was more common among women aged 18 to 24 compared with ≥35 years (PR, 1.15; CI, 1.10-1.21), and those who were uninsured compared with privately insured (PR, 1.33; CI, 1.27-1.39), but less common among Black/African American women compared with White women (PR, 0.93; CI, 0.89-0.96), those who preferred non-English languages for healthcare communication compared with English (PR, 0.85; CI, 0.81-0.90), and who initiated care in an emergency department compared with a women's health clinic (PR, 0.13; 95% CI, 0.12-0.15).
CONCLUSIONS: Completion of all required syphilis screening was low among pregnant women, highlighting a major gap in congenital syphilis prevention.
METHODS: A retrospective chart review was conducted among patients with a pregnancy episode-created at first prenatal care encounter or labor/delivery-at an NC health system from January 1, 2019 to December 31, 2023. We estimated the proportion with syphilis screening at timepoints required by NC law (before 28 weeks of gestation, 28-31 weeks of gestation, and within 1 week of delivery) using syphilis test dates and delivery dates. We estimated prevalence ratios (PR) and 95% confidence intervals (CIs) using log binomial regression with generalized estimating equations to explore associations between clinical and sociodemographic factors and syphilis screening.
RESULTS: We identified 64,803 pregnancies among 54,446 patients. Syphilis screening was conducted at least once in 99.5% of pregnancies. Only 27.6% had syphilis screening recorded at 28 to 31 weeks, and 22.0% had all required syphilis screening. Completion of required syphilis screening was more common among women aged 18 to 24 compared with ≥35 years (PR, 1.15; CI, 1.10-1.21), and those who were uninsured compared with privately insured (PR, 1.33; CI, 1.27-1.39), but less common among Black/African American women compared with White women (PR, 0.93; CI, 0.89-0.96), those who preferred non-English languages for healthcare communication compared with English (PR, 0.85; CI, 0.81-0.90), and who initiated care in an emergency department compared with a women's health clinic (PR, 0.13; 95% CI, 0.12-0.15).
CONCLUSIONS: Completion of all required syphilis screening was low among pregnant women, highlighting a major gap in congenital syphilis prevention.