Evaluating the Effectiveness of Spousal Testing Among Syphilis-Infected Pregnant Women in the Context of Mother-to-Child Transmission Elimination: A Multicenter Study in Southeastern China.

PURPOSE

Syphilis during pregnancy poses significant risks to maternal and neonatal health. Spousal testing is crucial for preventing congenital syphilis transmission. This study assessed spousal testing rates among syphilis-positive pregnant women to guide public health interventions.

METHODS

This multicenter effectiveness study was conducted in Southeast China, utilizing data from the Chinese HIV/AIDS, Syphilis, and Hepatitis B Prevention Information System between 2018 to 2024. Proportions were used to describe the sociodemographic characteristics of pregnant women with syphilis. Univariate and multivariate unconditional logistic regression models were used to analyze the factors associated with the testing status of spouses of pregnant women with syphilis.

RESULTS

A total of 4,875 spouses were tested for syphilis. Older gestational age at the first prenatal visit (aOR = 1.014, 95% CI: 1.007-1.022) and at delivery (aOR = 1.273, 95% CI: 1.011-1.602) were associated with lower rates of spousal testing. Spouses of women reported in 2022-2023 (aOR = 1.840, 95% CI: 1.465-2.311) had a higher likelihood of being untested. Unmarried status (aOR = 1.181, 95% CI: 1.022-1.364), junior high school education and below (aOR = 1.244, 95% CI: 1.121-1.381), no history of infection (aOR = 2.281, 95% CI: 2.073-2.510), and prenatal care in Grade II hospitals (aOR = 0.1.292, 95% CI: 1.140-1.464) were risk factors for spousal testing.

CONCLUSION

From 2018 to 2024, the spousal testing rate was 60%, with a syphilis positivity rate of 14.7%. Data revealed multiple risk factors, such as a late first pregnancy test, advanced age, unmarried status, lower education level, no history of syphilis infection, and selection of prenatal care in Grade II hospitals as delivery facilities. Recommendations include establishing specialized clinics, post-test spousal counseling, and routine spousal testing.