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Screening for Syphilis Infection During Pregnancy: US Preventive Services Task Force Reaffirmation Recommendation
, Michael Silverstein1, John B Wong2
1Brown University, Providence, Rhode Island.
Insights
Universal syphilis screening during pregnancy is recommended by the US Preventive Services Task Force (USPSTF). Early screening offers substantial benefits, preventing congenital syphilis and its severe infant complications.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Public Health
Background:
- Untreated syphilis in pregnant individuals can lead to congenital syphilis.
- Congenital syphilis causes severe infant health problems, including stillbirth, neonatal death, and developmental abnormalities.
- US congenital syphilis cases are at a 30-year high, with 3882 cases reported in 2023.
Purpose of the Study:
- To update evidence on the benefits and harms of screening for syphilis infection in pregnant individuals.
- To inform recommendations for syphilis screening in pregnancy.
Main Methods:
- Evidence-based review commissioned by the US Preventive Services Task Force (USPSTF).
- Focused on benefits and harms of syphilis screening in pregnant populations.
Main Results:
- Screening for syphilis infection in pregnancy demonstrates a substantial net benefit.
- High certainty supports the conclusion that screening is beneficial.
Conclusions:
- The USPSTF recommends universal, early screening for syphilis in pregnant individuals.
- Screening should occur at the first opportunity if not done early in pregnancy.
Importance:
Untreated syphilis infection during pregnancy can be passed to the fetus, causing congenital syphilis. Congenital syphilis is associated with premature birth, low birth weight, stillbirth, neonatal death, and significant abnormalities in the infant such as deformed bones, anemia, enlarged liver and spleen, jaundice, brain and nerve problems (eg, permanent vision or hearing loss), and meningitis. In 2023, there were 3882 cases of congenital syphilis in the US, including 279 congenital syphilis-related stillbirths and neonatal/infant deaths, the highest number reported in more than 30 years.
Objective:
The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update focused on the benefits and harms of screening for syphilis infection in pregnancy.
Population:
Adolescents and adults who are pregnant.
Evidence Assessment:
The USPSTF concludes with high certainty that screening for syphilis infection in pregnancy has a substantial net benefit.
Recommendation:
The USPSTF recommends early, universal screening for syphilis infection during pregnancy; if an individual is not screened early in pregnancy, the USPSTF recommends screening at the first available opportunity. (A recommendation).
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