Reported cases of congenital syphilis have increased dramatically since 2012. These rapidly rising diagnosis rates are cause for concern as congenital syphilis can cause severe morbidity, including stillbirth, irreversible neurodevelopmental delays, and neonatal death. Screening guidelines put forward by the United States Preventative Services Task Force recommend all women be screened for syphilis early in pregnancy. The Centers for Disease Control and Prevention (CDC) have issued more explicit guidelines, recommending screening during the first prenatal appointment with additional third trimester and delivery screening for pregnant women who are at high risk of syphilis. Although most states follow CDC recommendations and mandate syphilis screening during the first prenatal visit, state laws are variable regarding third trimester screening. Some states, such as Louisiana, mandate screening in the third trimester, while others, such as Kentucky, do not mention the third trimester at all in their screening guidelines.
In collaboration with the University of Kentucky, University of South Carolina’s Institute for Families in Society, and University of Louisiana Monroe, AcademyHealth’s Evidence-Informed State Health Policy Institute (ESHPI) is examining whether sexually transmitted infection (STI) history or other patient characteristics are associated with greater odds of syphilis screening among pregnant women enrolled in Medicaid in three states with elevated rates of congenital syphilis transmission. This work builds off a previous partnership between AcademyHealth’s ESHPI and the CDC Foundation that analyzed rates of syphilis testing among pregnant Medicaid enrollees as well as rates of chlamydia, gonorrhea, and syphilis testing among Medicaid beneficiaries who are taking PrEP.
This project is supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $638,064 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.