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Third-Trimester Prenatal Syphilis Screening: A Cost-Effectiveness Analysis.

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Summary
This summary is machine-generated.

Universal third-trimester syphilis rescreening is costly, preventing one case of congenital syphilis requires rescreening many women. The incidence of syphilis seroconversion must be significantly higher for rescreening to be cost-effective.

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Area of Science:

  • Public Health
  • Maternal-Fetal Medicine
  • Health Economics

Background:

  • Congenital syphilis poses significant risks to newborns.
  • Early screening and treatment are crucial for preventing adverse outcomes.
  • The cost-effectiveness of universal third-trimester syphilis rescreening remains a key question.

Purpose of the Study:

  • To estimate the cost of preventing congenital syphilis or fetal/neonatal death via universal third-trimester syphilis rescreening in the U.S.
  • To determine the syphilis seroconversion incidence threshold for cost-effective rescreening.

Main Methods:

  • A decision model compared universal third-trimester rescreening with no rescreening.
  • The model used an assumed base case seroconversion incidence of 0.012%.
  • Cost-effectiveness was defined as less than $285,000 per case of congenital syphilis prevented.

Main Results:

  • Universal rescreening costs an additional $419,842 per congenital syphilis case prevented.
  • Preventing one fetal or neonatal death costs $3,621,144 and $6,052,534, respectively.
  • A seroconversion incidence of 0.017% would make third-trimester rescreening cost-effective.

Conclusions:

  • Universal third-trimester syphilis rescreening is expensive and requires rescreening many women to prevent one adverse outcome.
  • The seroconversion incidence must be 19 times higher than the national average for universal rescreening to be cost-effective.