Key takeaways:
- Most girls with syphilis throughout being pregnant obtained well timed prenatal care.
- Substance use or a historical past of incarceration or homelessness throughout being pregnant was tied to insufficient or no syphilis remedy.
Variations in receiving sufficient and well timed remedy for syphilis throughout being pregnant spotlight the necessity to handle missed alternatives in syphilis testing and remedy, based on outcomes of a surveillance cohort research.
“Any well being care encounter throughout being pregnant is a chance to enhance outcomes for pregnant individuals and infants by guaranteeing syphilis screening and immediate remedy. Congenital syphilis is preventable with well timed testing and remedy previous to or early throughout being pregnant,” Ayzsa Tannis, MPH, epidemiologist on the CDC, advised Healio. “These information reveal distinctive insights into how we are able to higher defend pregnant individuals and their infants from syphilis.”
Tannis and colleagues evaluated information from 1,476 girls (median age, 27 years) with syphilis throughout being pregnant as of September 2023 from six collaborating jurisdictions in Arizona, Georgia, Michigan, New Jersey, New York and Washington recognized from the Surveillance for Rising Threats to Pregnant Individuals and Infants Community (SET-NET). Researchers in contrast demographic and scientific traits by syphilis stage and remedy standing throughout being pregnant and by prenatal care.
Of the contributors, 19.6% reported substance use throughout being pregnant, 8.5% reported a historical past of incarceration and 11.7% reported a historical past of homelessness. Fewer than half (40.8%) of contributors had been recognized with main, secondary or early latent syphilis and 59.2% had been recognized with late latent or unknown length syphilis.
Total, 82.2% of contributors obtained well timed prenatal care no less than 30 days earlier than the tip of being pregnant, 5.1% obtained nontimely prenatal care and 12.7% had no prenatal care. As well as, 57.9% had been adequately handled for syphilis throughout being pregnant, the researchers reported.
Of contributors who obtained well timed prenatal care, 17.3% obtained insufficient remedy and 14.8% didn’t obtain remedy. Members who obtained nontimely (RR = 2.5; 95% CI, 2.17-2.88) or no prenatal care (RR = 2.73; 95% CI, 2.47-3.02) had been extra more likely to obtain insufficient or no remedy, based on the research.
Girls who reported substance use (RR = 2.04; 95% CI, 1.82-2.28), historical past of incarceration (RR = 1.37; 95% CI, 1.11-1.69) or a historical past of homelessness (RR = 1.83; 95% CI, 1.58-2.13) throughout being pregnant had almost a twofold elevated chance of receiving insufficient or no remedy for syphilis, the researchers wrote.
Based on Tannis, along with enhancing entry to prenatal care, approaches to enhance syphilis care in settings outdoors of conventional prenatal care, together with EDs, substance use remedy amenities, jails, prisons and shelters serving unhoused individuals, are wanted.
“Extra analysis is required round syphilis testing and remedy, particularly extremely delicate and particular fast exams and oral remedy choices throughout being pregnant,” Tannis mentioned. “Efficient interventions would require modern, multidisciplinary partnerships.”
