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Author Spotlight: Advancing Syphilis Research — Innovations in Treponema pallidum Cultivation and Genetic Engineering
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Disparities in state-mandated third-trimester testing for syphilis.

Amelia C Clement1, Kathryn E Fay2, Lynn M Yee3

  • 1Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Drs Clement, Fay, and Yee); Division of Family Planning, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT (Dr Clement).

American Journal of Obstetrics & Gynecology MFM
|February 17, 2022
PubMed
Summary
This summary is machine-generated.

Despite a state mandate, third-trimester syphilis screening in pregnancy remains suboptimal, with significant disparities in adherence observed among diverse patient populations, highlighting persistent inequities in healthcare.

Keywords:
congenital syphilishealth policyhealthcare disparitiesprenatal caresexually transmitted infection

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Maternal Health

Background:

  • Illinois mandates first-visit and third-trimester syphilis testing for all pregnancies.
  • Syphilis incidence is rising nationally and statewide, increasing risks for congenital syphilis.
  • Adherence to state-mandated infectious disease screening and associated disparities remain largely unknown.

Purpose of the Study:

  • To evaluate compliance with Illinois's state-mandated third-trimester syphilis testing.
  • To identify demographic and clinical disparities in syphilis testing adherence.

Main Methods:

  • Retrospective cohort study of pregnant individuals delivering between January 2015 and February 2018.
  • Included patients delivering after 28 weeks of gestation.
  • Analyzed completion of third-trimester syphilis screening using multivariable logistic regression.

Main Results:

  • Only 27.3% of 9048 eligible deliveries received third-trimester syphilis screening.
  • Screening rates increased significantly over the study period, from 5.8% to 59.8%.
  • Non-Hispanic Black/Hispanic race/ethnicity, non-English language, public insurance, younger age, multiparity, and higher BMI were associated with increased screening.

Conclusions:

  • Third-trimester syphilis screening adherence was suboptimal despite a state mandate.
  • Demographic factors associated with screening suggest inequities and bias in testing practices.
  • Legal mandates alone do not eliminate health disparities in syphilis screening.