Syphilis screening during pregnancy in 18- to 49-year-old women in commercially-insured claims data, 2022.

Background: Syphilis cases continue to climb in the United States, with a 159% increase among women between 2018 and 2022. Congenital syphilis (CS) cases continued along the same trajectory, with a 183% increase over the same time frame. Adherence to the screening guidelines may assist in reducing this trend. Our analysis aimed to determine the proportion of commercially-insured women receiving syphilis screening during pregnancy.

Materials And Methods: We analyzed the 2022 Merative™ MarketScan® Database containing commercially-insured medical claims to determine syphilis screening rates among insured pregnant women aged 18-49 years old, insured for eight months prior to childbirth. Screening events were classified into three categories: 1st (1-13 weeks), 2nd (14-27 weeks), and 3rd (28+ weeks). Percentages and odds ratios were calculated for pregnancy categories by age category, trimester, Centers for Medicare and Medicaid Services (CMS) regions, employment, and type of health insurance.

Results: Of the 170,005 pregnant women in the sample, 79.6% were screened for syphilis at least once, and 95.1% resided in a state requiring syphilis testing during pregnancy. The highest percentage of pregnant women were screened during the 3rd trimester, and the majority of those screened received at least 2 tests during pregnancy. Women in states with laws had 14% greater odds for receiving any screening during pregnancy.

Discussion: Despite Centers for Disease Control and Prevention (CDC) syphilis screening recommendations, only 79.6% received screening among this insured population. Effective communication on the importance of syphilis screening for all medical providers and their patients may increase the screening rates and decrease the incidence of CS.