Lanier Paul, Kennedy Susan, Snyder Angela, Smith Jessica, Napierala Eric, Talbert Jeffrey, Hammerslag Lindsey, Humble Larry, Myers Eddy, Austin Anna, Blount Thomas, Dowler Shannon, Mobley Victoria, Fede Ana Lòpez-De, Nguyen Hoa, Bruce Jean, Grijalva Carlos G, Krishnan Sunita, Otter Caitlin, Horton Katie, Seiler Naomi, Majors John, Pearson William S
School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
AcademyHealth, Washington, District of Columbia.
Am J Prev Med. 2022 May;62(5):770-776. doi: 10.1016/j.amepre.2021.11.011. Epub 2022 Jan 6.
The rates of syphilis among pregnant women and infants have increased in recent years, particularly in the U.S. South. Although state policies require prenatal syphilis testing, recent screening rates comparable across Southern states are not known. The purpose of this study is to measure syphilis screening among Medicaid enrollees with delivery in states in the U.S. South.
A total of 6 state-university research partnerships in the U.S. South developed a distributed research network to analyze Medicaid claims data using a common analytic approach for enrollees with delivery in fiscal years 2017-2018 and 2018-2019 (combined N=504,943). In 2020-2021, each state calculated the percentage of enrollees with delivery with a syphilis screen test during the first trimester, third trimester, and at any point during pregnancy. Percentages for those with first-trimester enrollment were compared with the percentages of those who enrolled in Medicaid later in pregnancy.
Prenatal syphilis screening during pregnancy ranged from 56% to 91%. Screening was higher among those enrolled in Medicaid during the first trimester than in those enrolled later in pregnancy.
Despite state laws requiring syphilis screening during pregnancy, screening was much lower than 100%, and states varied in syphilis screening rates among Medicaid enrollees. Findings indicate that access to Medicaid in the first trimester is associated with higher rates of syphilis screening and that efforts to improve access to screening in practice settings are needed.
近年来，孕妇和婴儿梅毒感染率有所上升，尤其是在美国南部。尽管州政策要求进行产前梅毒检测，但南部各州近期的筛查率是否可比尚不清楚。本研究的目的是衡量美国南部各州医疗补助计划参保人中梅毒筛查的情况。
美国南部的6个州立大学研究伙伴关系建立了一个分布式研究网络，采用通用分析方法分析2017 - 2018财年和2018 - 2019财年分娩的医疗补助计划参保人的报销数据（合并样本量N = 504,943）。在2020 - 2021年，每个州计算了在孕早期、孕晚期以及孕期任何时间进行梅毒筛查的参保人分娩的百分比。将孕早期参保人的百分比与孕期后期加入医疗补助计划的参保人的百分比进行比较。
孕期梅毒产前筛查率在56%至91%之间。孕早期加入医疗补助计划的参保人的筛查率高于孕期后期加入的参保人。
尽管州法律要求孕期进行梅毒筛查，但筛查率远低于100%，且各州医疗补助计划参保人的梅毒筛查率存在差异。研究结果表明，孕早期加入医疗补助计划与更高的梅毒筛查率相关，并且需要在实际医疗环境中努力改善筛查的可及性。
