Emerson Brian, Tao Guoyu, Hufstetler Kaitlin, Cramer Ryan, Pearson William S
From the Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Sex Transm Dis. 2025 May 1;52(5):295-303. doi: 10.1097/OLQ.0000000000002089. Epub 2025 Mar 4.
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.
We analyzed the 2022 Merative MarketScan Database containing commercially insured medical claims to determine syphilis screening rates among insured pregnant women aged 18 to 49 years, insured for 8 months before childbirth. Screening events were classified into 3 categories: first (1-13 weeks), second (14-27 weeks), and third (28+ weeks). Percentages and odds ratios were calculated for pregnancy categories by age category, trimester, Centers for Medicare & Medicaid Services regions, employment, and type of health insurance.
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 was screened during the third 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.
Despite Centers for Disease Control and Prevention 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.
美国梅毒病例持续攀升，2018年至2022年间女性病例增加了159%。先天性梅毒（CS）病例也呈同样的上升趋势，在同一时期内增加了183%。遵守筛查指南可能有助于减缓这一趋势。我们的分析旨在确定孕期接受梅毒筛查的商业保险女性的比例。
我们分析了2022年包含商业保险医疗理赔数据的默克多市场扫描数据库，以确定年龄在18至49岁、分娩前参保8个月的参保孕妇的梅毒筛查率。筛查事件分为三类：首次（1 - 13周）、第二次（14 - 27周）和第三次（28周及以后）。按年龄类别、孕期、医疗保险和医疗补助服务中心地区、就业情况以及医疗保险类型计算各妊娠类别的百分比和优势比。
在样本中的170,005名孕妇中，79.6%至少接受过一次梅毒筛查，95.1%居住在要求孕期进行梅毒检测的州。孕期接受筛查的孕妇比例最高的是孕晚期，且大多数接受筛查的孕妇在孕期至少接受了2次检测。有相关法律的州的女性孕期接受任何筛查的几率高出14%。
尽管疾病控制与预防中心有梅毒筛查建议，但在这一参保人群中只有79.6%接受了筛查。对所有医疗服务提供者及其患者就梅毒筛查的重要性进行有效沟通，可能会提高筛查率并降低先天性梅毒的发病率。
