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Updated: Mar 20, 2026
FISH for Pre-implantation Genetic Diagnosis
Published on: February 23, 2011
Syphilis screening in pregnancy in the United Kingdom, 2010-2011: a national surveillance study
C L Townsend1, K Francis1, C S Peckham1
1Population, Policy and Practice Programme, UCL Institute of Child Health, University College London, London, UK.
Insights
A national review of antenatal syphilis screening in the UK found that 25% of positive screens were new infections. Improved early detection and treatment are crucial for better maternal and infant outcomes in syphilis management.
Area of Science:
- Public Health
- Infectious Diseases
- Maternal Health
Background:
- Syphilis screening during pregnancy is vital for preventing congenital syphilis.
- The national antenatal syphilis screening programme in the UK aims to detect and manage infections effectively.
- Evaluating the programme provides insights into current screening and treatment strategies.
Purpose of the Study:
- To assess the effectiveness of the UK's national antenatal syphilis screening programme.
- To identify areas for improvement in screening and management of syphilis in pregnant women.
- To provide evidence-based recommendations for enhancing antenatal syphilis control.
Main Methods:
- A national population-based surveillance study was conducted in the United Kingdom.
- Data were collected from approximately 210 UK antenatal units between 2010 and 2011.
- Information included demographic, laboratory, and treatment details for pregnant women with positive syphilis screens and follow-up infant data.
Main Results:
- Over 77% of reported pregnancies had confirmed positive syphilis screening results.
- Of those with positive screens, 40% required treatment, with 26% representing newly diagnosed infections.
- Treatment uptake was high (96%), but 18% of treatments were initiated in the third trimester; infant follow-up was poor, with six cases of congenital syphilis identified.
Conclusions:
- A significant proportion of pregnant women with positive syphilis screens required treatment, highlighting the need for effective management.
- Improvements in antenatal syphilis management are necessary, focusing on earlier detection and treatment initiation.
- Strengthening collaboration between healthcare teams is essential for optimizing syphilis screening and care during pregnancy.
Objective:
To evaluate the national antenatal syphilis screening programme and provide evidence for improving screening and management strategies.
Design:
National population-based surveillance.
Setting:
United Kingdom (UK).
Population:
All pregnant women screening positive for syphilis, 2010-2011.
Methods:
Demographic, laboratory and treatment details for each pregnancy were collected from UK antenatal units (~210), along with follow-up information on all infants born to women requiring syphilis treatment in pregnancy.
Main Outcome Measures:
Proportion of women with newly or previously diagnosed syphilis among those with positive screening tests in pregnancy; proportion requiring treatment.
Results:
Overall, 77% (1425/1840) of reported pregnancies were confirmed syphilis screen-positive. Of these, 71% (1010/1425) were in women with previously diagnosed syphilis (155 requiring treatment), 26% (374/1425) with newly diagnosed syphilis (all requiring treatment) and 3% (41/1425) required treatment but the reason for treatment was unclear. Thus 40% (570/1425) required treatment overall; of these, 96% (516/537) were treated (missing data: 33/570), although for 18% (83/456), this was not until the third trimester (missing data: 60/537). Follow up of infants born to treated women was poor, with at least a third not followed. Six infants were diagnosed with congenital syphilis; two mothers were untreated, three had delayed treatment and one had incomplete treatment (first trimester).
Conclusion:
Over 2 years, among pregnant women with confirmed positive syphilis screening results in the UK, a quarter had newly diagnosed infections and 40% required treatment. Despite high uptake of treatment, antenatal syphilis management could be improved by earlier detection, earlier treatment, and stronger links between healthcare teams.
Tweetable Abstract:
25% of pregnant women screening positive for syphilis in the UK were newly diagnosed and 40% needed treatment.
