Task force recommends screening all pregnant people for syphilis

Key takeaways:

• Cases of congenital syphilis increased 10 times from 2012 to 2022.
• According to a USPSTF member, 90% of congenital syphilis cases could be prevented with timely testing and treatment.

The U.S. Preventive Services Task Force released a draft recommendation encouraging physicians to screen for syphilis in people who are pregnant as early as possible.

The recommendation, an A-grade, is consistent with the task force’s 2018 recommendation on the topic.

“Cases of congenital syphilis are 10 times higher now than they were a decade ago,” USPSTF member Carlos Jaén, MD, PhD, MS, FAAFP, the Dr. and Mrs. James L. Holly distinguished chair in the department of family and community medicine at the Joe R. and Teresa Lozano Long School of Medicine at The University of Texas Health Science Center at San Antonio, said in a press release. “Fortunately, screening for syphilis early in pregnancy is an effective way to identify the infection so it can be treated, improving the health of both the pregnant person and their baby.”

According to the CDC, more than 3,700 congenital syphilis cases were reported in 2022.

The task force noted that congenital syphilis can result in health complications, such as premature birth and hearing or vision loss, when left untreated.

In the evidence review, the researchers examined studies published since 2017 on the benefits and harms of screening for syphilis in people who are pregnant.

The expert panel did not identify any new studies examining the effectiveness of syphilis screening.

The researchers concluded that the evidence remained consistent with prior reviews on syphilis screening and “supports the need for two-step serologic screening to reduce false screening results.”

The task force underlined that people who are pregnant should be screened as early as possible, such as at their first prenatal visit or the first time they see a health care provider during their pregnancy, and that it is essential that people who screen positive receive evidence-based evaluation and treatment.

Black, Hispanic, Native American and Alaska Native people who are pregnant are disproportionally affected by the infection, being eight times more likely to have babies with congenital syphilis, the USPSTF said.

The task force added that these disparities are likely due to structural and social factors that affect health care behaviors and access and called for further research on ways to reduce these disparities.

“Almost 90% of cases of congenital syphilis could have been prevented with timely testing and treatment,” USPSTF vice chair Michael Silverstein, MD, MPH, the George Hazard Crooker University professor of health services, policy and practice at the Brown University School of Public Health and the director of Brown University’s Hassenfeld Child Health Innovation Institute, said in the release. “It is essential to address barriers to care to ensure that all pregnant people get screened and those who screen positive receive timely, equitable and evidence-based care.”

Comments on the draft recommendation can be submitted here from Nov. 19 through Dec. 23.

References:

• Screening for Syphilis Infection in Pregnant Persons: A Draft Limited Systematic Evidence Review Update for the U.S. Preventive Services Task Force. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/syphilis-infection-pregnant-persons. Accessed Nov. 19, 2024.
• Screening for Syphilis Infection in Pregnant Persons: U.S. Preventive Services Task Force Draft Reaffirmation Recommendation Statement. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/syphilis-infection-pregnant-persons. Accessed Nov. 19, 2024.
• U.S Preventive Services Task Force issues draft recommendation statement on screening for syphilis in pregnancy. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/syphilis-pregnancy-draft-rec-bulletin.pdf. Accessed Nov. 19, 2024.
• U.S. syphilis cases in newborns continue to increase: A 10-times increase over a decade. Available at: https://www.cdc.gov/media/releases/2023/s1107-newborn-syphilis.html. Published Nov. 7, 2023. Accessed Nov. 19, 2024.