Provider Adherence to Syphilis Testing Guidelines Among Stillbirth Cases.

Area of Science:

• Obstetrics and Gynecology
• Infectious Disease Screening
• Public Health Surveillance

Background:

• The Centers for Disease Control and Prevention (CDC) recommends syphilis testing for all women following a stillbirth.
• Current adherence to these CDC guidelines for syphilis screening in stillbirth cases requires evaluation.

Purpose of the Study:

• To assess the adherence to CDC guidelines for syphilis screening among women who experienced a stillbirth delivery.
• To evaluate the rates of syphilis testing before and after stillbirth delivery.

Main Methods:

• Utilized electronic health records from January 1, 2014, to December 31, 2016, for women aged 18-44 with stillbirth diagnoses.
• Confirmed stillbirth diagnoses through medical chart reviews.
• Estimated proportions of women tested for syphilis within 300 days before and 30 days after stillbirth delivery.

Main Results:

• Identified 1111 stillbirths among 865,429 women; chart review confirmed only 27.6% of suspected stillbirth cases.
• Among confirmed stillbirths, 51.4% received any syphilis testing.
• Testing rates were 31.4% before, 42.9% after, and 22.9% both before and after stillbirth delivery.

Conclusions:

• A significant majority of women with stillbirth delivery do not adhere to CDC-recommended syphilis screening protocols.
• International Classification of Diseases (ICD) codes for stillbirth lack accuracy, complicating case identification for screening adherence studies.